Nebulized Colistin shows better microbiological clearance in Ventilator associated pneumonia

A recent study published in the Journal of Critical Care found Nebulized Colistin (NC) to be associated with better microbiological clearance but did not result impact the prognosis of ventilator-associated pneumonia (VAP). 

The study by Xiaoyu Zhang and colleagues undertook an extensive search across databases including Web of Science, PubMed, Embase, and the Cochrane Library, amassed a collection of three randomized controlled trials (RCTs) and seven observational studies. These investigations aimed to discern whether NC holds the promise it initially appeared to offer.

The primary focus was on clinical response, with secondary outcomes encompassing microbiological eradication, overall mortality, length of mechanical ventilation (MV), duration of intensive care unit stay (ICU-LOS), as well as potential adverse effects including nephrotoxicity, neurotoxicity, and bronchospasm.

Remarkably, the results indicate that while NC demonstrated a higher rate of microbiological eradication, it failed to significantly outperform traditional intravenous antibiotic therapy in terms of clinical response, overall mortality, MV duration, and ICU-LOS. This equilibrium between the two treatment approaches suggests that while NC may excel in combatting microbial pathogens, it does not translate into substantial changes in patient prognosis.