Abstract

Introduction: Treatment with inhaled colistin in chronic Pseudomonas aeruginosa bronchial infection in patients with non-cystic fibrosis bronchiectasis is gaining prominence.

Objectives: To evaluate the relationship between the use of inhaled colistin and the eradication of Pseudomonas aeruginosa (PA), induction of resistance, exacerbations and lung function.

Methods: Retrospective before-after study in patients with bronchiectasis and persistence of PA in sputum treated for at least one year with inhaled colistin from 2009-2015. The functional tests, sputum microbiology, number and type of exacerbations (hospital and non-hospital) were analyzed 1 year before and after the use of inhaled colistin.

Results: The study included 49 patients with an average age of 72 years (SD± 10); 30 (61%) males.

After 1 year of treatment with inhaled colistin: 55% PA sputum cultures were negative (p <0.0001) and 45% positive PA and sensitive to colistin, while there was a decrease in non hospital exacerbations of 2 (SD ± 1.4) to 1 (SD ± 0.7 ) on average (p <0.001) and of hospital exacerbations from 65% to 22.5% (p <0.001). The walking test in patients with persistent positive cultures for PA decreased a mean of 42 mts (SD ± 77) (p=0.033).

Conclusions: Inhaled colistin produces a significant eradication of PA in sputum cultures and a decrease in exacerbations. The long-term treatment with colistin did not induce resistance to PA. In spite of the treatment with inhaled colistin, patients with persistent positive cultures for PA showed a significant reduction in exercise capacity.