ReviewMicroorganisms2021
Nebulized Colistin in Ventilator-Associated Pneumonia and Tracheobronchitis: Historical Background, Pharmacokinetics and Perspectives.
Review in Microorganisms, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06488794 (Nebulised Colistimethate Sodium to Prevent Pediatric Ventilator-associated Pneumonia), which is not on this map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Nebulised Colistimethate Sodium to Prevent Pediatric Ventilator-associated Pneumonia: The COLIPED Investigation
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Prevalence of colistin resistance in clinicalFuture microbiology · 2025Pooled it
- Efficacy of adjunctive inhaled colistin and tobramycin for ventilator-associated pneumonia: systematic review and meta-analysis.BMC pulmonary medicine · 2024Pooled it
- Randomized control study of nebulized colistin as an adjunctive therapy in ventilator-associated pneumonia in pediatric postoperative cardiac surgical population.Annals of cardiac anaesthesiaTrial
- Adjunctive inhaled antibiotics should not necessarily be considered independently of the systemic antibiotic regimen.Critical care (London, England) · 2026Article
- Combination of aztreonam, colistin and tigecycline in the treatment of neonatal carbapenemase-producing Enterobacteriaceae infection: a case report.BMC pediatrics · 2026Article
- Clinical Outcomes of Aerosolized Versus Intravenous Colistin in Ventilator-Associated Pneumonia Caused by Multidrug-Resistant Gram-Negative Bacteria.Journal of clinical medicine research · 2026Article
- Comparison of different colistin sulfate regimens for carbapenem-resistant gram-negative bacteria pneumonia in neurocritical care patients: a retrospective cohort study.Antimicrobial agents and chemotherapy · 2025Article
- The relationship between the alveolar epithelial lining fluid concentration of intravenous plus inhaled polymyxin B and clinical efficacy in patients with pneumonia caused by carbapenem-resistant gram-negative bacilli: a prospective cohort study.BMC infectious diseases · 2025Article
- Salvage Therapy Against Infections of MDRMicroorganisms · 2025Article
- Nebulized Antibiotics for Preventing and Treating Gram-Negative Respiratory Infections in Critically Ill Patients: An Overview of Reviews.Antibiotics (Basel, Switzerland) · 2025Review
- Analysis and comparison of adverse events of colistin administered by different routes based on the FAERS database.Scientific reports · 2025Article
- Tolerance and effectiveness of inhaled antibiotics at standard or low doses in COPD patients with chronic Pseudomonas aeruginosa bronchial infection.Scientific reports · 2025Observational
- Utilizing a three-dimensional printed additional nebulization chamber for colistin nebulization with a large diluent volume through a vibrating mesh nebulizer: proof of concept.European clinical respiratory journal · 2025Article
- Prevention of donation-related infections: investigating the use of antibiotics in the decontamination of preservation fluid for organ transplantation.Frontiers in cellular and infection microbiology · 2025Article
- Coacervation in Slow Motion: Kinetics of Complex Micelle Formation Induced by the Hydrolysis of an Antibiotic Prodrug.Molecular pharmaceutics · 2024Article
- Lessons Are Still Being Learned about Intrapulmonary Antibiotic Concentrations.American journal of respiratory and critical care medicine · 2024Article
- Intrapulmonary and Systemic Pharmacokinetics of Colistin Following Nebulization of Low-Dose Colistimethate Sodium in Patients with Ventilator-Associated Pneumonia Caused by Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2024Article
- Understanding the nebulisation of antibiotics: the key role of lung microdialysis studies.Critical care (London, England) · 2024Review
- Colistin Effects on Emphysematous Lung in an LPS-Sepsis Model.Antibiotics (Basel, Switzerland) · 2023Article
- Inhaled drug delivery: a randomized study in intubated patients with healthy lungs.Annals of intensive care · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 8 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clinical 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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.