efficacy of inhaled colistin in critically ill children with ventilator-associated pneumonia resistant to multiple drugs

Background: ventilator-associated pneumonia (vap) is the leading cause of death related to mechanical ventilation and the most common nosocomial infection in the intensive care unit (icu).objectives: this study aimed to investigate the efficacy of adjunctive inhaled colistin in critically ill children with multidrug-resistant ventilator-associated pneumonia (mdr-vap). methods: in this prospective cohort study, 80 critically ill patients aged 2 to 18 years with mdr-vap were admitted to the picu of mofid children's hospital in tehran between 2019 and the end of 2022. eligible patients were divided into two equal groups: the colistin group (receiving inhaled colistin in addition to other antibiotics) and the control group (receiving only intravenous antibiotics). clinical and laboratory findings were compared between the two groups. results: the mean ages of participants in the control and colistin groups were 21.2 ± 2.9 and 24.9 ± 1.7 months, respectively (p = 0.51). the duration of hospital stay in the colistin group was 34.92 ± 20.03 days, compared to 29.83 ± 22.35 days in the control group, which was not statistically significant (p = 0.29). the duration of mechanical ventilation use was similar between the control group (23.15 ± 21.17 days) and the colistin group (24.06 ± 17.87 days) (p = 0.83). mortality rates were also comparable, with 65% in the control group and 57.5% in the colistin group (p = 0.49). conclusions: inhaled colistin did not significantly reduce the duration of hospitalization, the duration of mechanical ventilation use, or the mortality rate in critically ill children with mdr-vap. further multicenter studies with larger sample sizes are recommended to validate these findings.