Evaluation of Inhaled Colistin/Fosfomycin as an Adjunctive Treatment for Ventilator‐Associated Pneumonia: A Preliminary Study
Abstract
ABSTRACT Background and Aims Ventilator‐associated pneumonia (VAP) caused by gram‐negative bacteria is associated with significant complications, mortality, and resource utilization. Over the past decade, there has been growing interest in using fosfomycin to treat multidrug‐resistant gram‐negative infections, particularly when limited viable options remain. This study aimed to investigate the efficacy of inhaled colistin/fosfomycin as an adjunctive treatment for VAP. Methods In this triple‐blind clinical trial, participants with VAP caused by extensively drug‐resistant (XDR) Acinetobacter baumannii were randomly assigned to two groups. Both groups received meropenem (2 g as a 4 h extended infusion every 8 h) and intravenous colistin (9 million IU loading dose, followed by 4.5 million IU every 12 h). The control group was treated with inhaled colistin (1 million IU every 8 h), while the intervention group received a combination of inhaled colistin (1 million IU every 8 h) and fosfomycin (80 mg every 12 h). Clinical pulmonary infection score (CPIS) was measured at baseline and upon completion of the intervention. Acute kidney injury (AKI) rates during treatment, as well as clinical response and microbiological outcomes, were compared between the two groups. Results While the differences were not statistically significant ( p = 0.19), the failure rate was lower in the colistin/fosfomycin group ( n = 3; 7.7%) compared to the colistin group ( n = 7; 18.9%). The…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 19 participants or records.
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