Ингаляционный полимиксин в лечении пожилых пациентов с тяжелой внебольничной пневмонией, вызванной Klebsiella pneumoniae

Background. Inhaled administration of antibacterial drugs (ABD) is a new insufficiently studied area of modern pulmonology. Its feasible advantages comprise a targeted drug delivery to the infection site, amplified antibiotic concentration in tracheobronchial secretion and reduced systemic toxicity risks. The most common inhaled ABDs include aminoglycosides and polymyxin­E (colistin). Aim. A comparison of patient cohorts with severe community­acquired pneumonia induced by Klebsiella pneumoniae  receiving and not receiving inhaled colistin. Materials and methods. The study conducted is a retrospective multicentre controlled non­randomised assay. Among the 45 patients included, 20 were and 25 were not receiving colistin inhalation. The endpoint was survival. Data were analysed with Statistica 6.0. Results and discussion . The cohorts differed significantly neither in the main clinical and laboratory values, nor in point scoring of severity and outcome. However, statistical significance was obtained for differences in the ALV ( p = 0.04) and pneumonia resolution ( p = 0.044) times. Conclusion . Inhaled polymyxin­supplemented therapy for severe community­acquired pneumonia induced by Kl. pneumoniae significantly reduces the ALV and pneumonia resolution times in elderly and senile patients but does not affect survival.