Role of nebulized colistin as a substitutive strategy against nosocomial pneumonia caused by carbapenem-resistant Gram-negative bacterial (CR-GNB) in intensive care units: a retrospective cohort study
Main finding · Clinical failure rate, PS-matched cohortResult — go to the resultAdjusted odds ratio 0.48 95% CI 0.27–0.87Authors' conclusion
In ICU-admitted patients with nosocomial pneumonia caused by colistin-susceptible CRGNB, substitutive nebulized colistin was associated with better clinical outcomes.
Study context
- Population
- Intensive care unit (ICU) patients with nosocomial pneumonia caused by colistin-susceptible CR-GNB, without IV colistin treatment
- Participants
- 343 vs 214
- Exposure
- Nebulized colistin vs No nebulized colistin
- Nebulized colistinn = 343
- No nebulized colistinn = 214reference
- Outcome
- Clinical failure (clinical effectiveness of substitutive nebulized colistin in treatment outcomes)
Methodological detailspropensity score (PS)-matched
- Propensity score (PS)-matched
Main finding
Clinical failure rate, PS-matched cohort · Day 14
Adjusted odds ratio
0.48
95% CI 0.27–0.87
By group
Nebulized colistin
27.0
%
No nebulized colistin
42.6%
Nebulized colistin vs No nebulized colistin
aOR 0.48 (95% CI 0.27–0.87)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Clinical failure rate, PS-matched cohort · Day 28
P = 0.027
| Outcome | aOR (95% CI) | |
|---|---|---|
| Clinical failure, original cohort (multivariate analysis) · Day 14 | 0.45 (0.30–0.67) | |
| 0.20.5125Adjusted odds ratio (log scale) |
| Outcome | Nebulized colistin | No nebulized colistin | P value |
|---|---|---|---|
| Clinical failure rate, PS-matched cohort · Day 7 | 22.6 % | — not stated in the abstract | P = 0.001 |
— not stated in the abstract
Clinical failure and mortality, high (> 6 MIU/day) vs low (≤ 6 MIU/day) dose nebulized colistin, PS-matched cohort (subgroup)
- No differences in clinical failure rate and mortality rate between high and low dose
Original publication
Role of nebulized colistin as a substitutive strategy against nosocomial pneumonia caused by CR-GNB in intensive care units: a retrospective cohort study. Ann Intensive Care. Published 7 January 2023. doi:10.
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