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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorZhu, Yinggang
dc.contributor.authorMonsel, Antoine
dc.contributor.authorRoberts, Jason A.
dc.contributor.authorPontikis, Konstantinos
dc.contributor.authorMimoz, Olivier
dc.contributor.authorRello Condomines, Jordi
dc.date.accessioned2021-12-16T12:32:23Z
dc.date.available2021-12-16T12:32:23Z
dc.date.issued2021-05-27
dc.identifier.citationZhu Y, Monsel A, Roberts J, Pontikis K, Mimoz O, Rello J, et al. Nebulized Colistin in Ventilator-Associated Pneumonia and Tracheobronchitis: Historical Background, Pharmacokinetics and Perspectives. Microorganisms. 2021 May 27;9(6):1154.
dc.identifier.issn2076-2607
dc.identifier.urihttp://hdl.handle.net/11351/6700
dc.descriptionColistin; Phramacokinetic; Technique of nebulization
dc.description.abstractClinical evidence suggests that nebulized colistimethate sodium (CMS) has benefits for treating lower respiratory tract infections caused by multidrug-resistant Gram-negative bacteria (GNB). Colistin is positively charged, while CMS is negatively charged, and both have a high molecular mass and are hydrophilic. These physico-chemical characteristics impair crossing of the alveolo-capillary membrane but enable the disruption of the bacterial wall of GNB and the aggregation of the circulating lipopolysaccharide. Intravenous CMS is rapidly cleared by glomerular filtration and tubular excretion, and 20–25% is spontaneously hydrolyzed to colistin. Urine colistin is substantially reabsorbed by tubular cells and eliminated by biliary excretion. Colistin is a concentration-dependent antibiotic with post-antibiotic and inoculum effects. As CMS conversion to colistin is slower than its renal clearance, intravenous administration can lead to low plasma and lung colistin concentrations that risk treatment failure. Following nebulization of high doses, colistin (200,000 international units/24h) lung tissue concentrations are > five times minimum inhibitory concentration (MIC) of GNB in regions with multiple foci of bronchopneumonia and in the range of MIC breakpoints in regions with confluent pneumonia. Future research should include: (1) experimental studies using lung microdialysis to assess the PK/PD in the interstitial fluid of the lung following nebulization of high doses of colistin; (2) superiority multicenter randomized controlled trials comparing nebulized and intravenous CMS in patients with pandrug-resistant GNB ventilator-associated pneumonia and ventilator-associated tracheobronchitis; (3) non-inferiority multicenter randomized controlled trials comparing nebulized CMS to intravenous new cephalosporines/ß-lactamase inhibitors in patients with extensive drug-resistant GNB ventilator-associated pneumonia and ventilator-associated tracheobronchitis.
dc.language.isoeng
dc.publisherMDPI
dc.relation.ispartofseriesMicroorganisms;9(6)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectPneumònia - Tractament
dc.subjectMedicaments antibacterians - Ús terapèutic
dc.subjectMalalties bacterianes gramnegatives - Tractament
dc.subject.meshPneumonia, Ventilator-Associated
dc.subject.mesh/drug therapy
dc.subject.meshAnti-Bacterial Agents
dc.subject.mesh/administration & dosage
dc.titleNebulized Colistin in Ventilator-Associated Pneumonia and Tracheobronchitis: Historical Background, Pharmacokinetics and Perspectives
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.3390/microorganisms9061154
dc.subject.decsneumonía asociada al ventilador
dc.subject.decs/farmacoterapia
dc.subject.decsantibacterianos
dc.subject.decs/administración & dosificación
dc.relation.publishversionhttps://doi.org/10.3390/microorganisms9061154
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Zhu Y] Department of Pulmonary and Critical Care Medicine, Hua-Dong Hospital, Fudan University, Shanghai 200433, China. [Monsel A] Multidisciplinary Intensive Care Unit, Department of Anaesthesiology and Critical Care, La Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Medicine Sorbonne University, 75012 Paris, France. Unité Mixte de Recherche (UMR)-S 959, Immunology-Immunopathology-Immunotherapy (I3), Institut National de la Santé et de la Recherche Médicale (INSERM), 75012 Paris, France. Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France. [Roberts JA] Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France. University of Queensland Centre for Clinical Research, Faculty of Medicine The University of Queensland, 4006 Brisbane, Australia. Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women’s Hospital, 4006 Brisbane, Australia. Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, 30029 Nîmes, France. [Pontikis K] Intensive Care Unit, First Department of Respiratory Medicine, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece. [Mimoz O] Anaesthesiology and Intensive Care Department, University Hospital of Poitiers, University of Poitiers, 86000 Poitiers, France. [Rello J] Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain. Recerca Clínica/Innovació en la Pneumònia i Sèpsia (CRIPS), Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Clinical Research, CHU Nîmes, Université Montpellier-Nîmes, 30029 Nîmes, France
dc.identifier.pmid34072189
dc.identifier.wos000666104300001
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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