RT Journal Article SR Electronic T1 Inhaled colistin on Acinetobacter baumannii treatment JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P1999 VO 40 IS Suppl 56 A1 Gustavo Coimbra dos Reis A1 Ana Martins A1 Luís Bento YR 2012 UL http://erj.ersjournals.com/content/40/Suppl_56/P1999.abstract AB Introduction: Ventilator associated pneumonia and tracheobronchitis (VAP/VAT) due to multiresistant A. baumannii are preeminent causes of mortality and morbidity at ICU's. Inhaled antibiotics, allowing high antibiotic concentrations at airways and secretions, are described as an alternative or complement to systemic therapy.Objectives: Primary – microbiology outcome on A. baumannii VAP/VAT treatment with inhaled colistin; loss of polymyxin sensitivity after inhaled colistin. Secondary – characterization of clinical outcome; of the A. baumannii isolated; of inhaled colistin use; of systemic antibiotic co-administration; of ICU and hospital mortality.Material and Methods: Observational, longitudinal, retrospective study, through file consult, of patients admitted at UUM from 01/2005 to 12/2011, with A. baumannii VAP/TAV, treated with inhaled colistin.Results: 23pts included, 18 male, mean age 70±18 yrs, with mean IUC admission APACHE II and SAPS II score of 23 and 54. Microbiologic eradication was achieved on 19 (83%), with 4 relapses. At failure to eradicate or relapse no change was observed on resistance profile. Clinically, there was a positive evolution of SOFA and Oxygenation Index with treatment. A. baumannii was extensively resistant in all cases, being sensible only to polymyxins in 20 (87%). Mean inhaled colistin diary dose was 3.5^6u (1^6u-6^6u), with a mean duration of 7.8±3.5 days. Systemic colistin was co-administrated in 6pts, with 100% eradication rate and only one relapse. ICU and hospital mortality was 4.3% and 39%.Conclusions: On critical patients, inhaled colistin was effective treating PAV/TAV due to extensively resistant A. baumannii. No change on antibiotic resistance profile occurred after treatment.