Colistin
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Bronchospasm following administration of a nebulised preparation: case report A 63-year-old man experienced bronchospasm and was hospitalised after inhalation of nebulised colistin for the treatment of a chronic, multidrug resistant Pseudomonas aeruginosa infection. Approximately 1 year after the man first started receiving intermittent (28 days on/28 days off) treatment with colistin 1 MIU (80mg), with no adverse effects, his condition necessitated reinstatement of treatment. Within minutes of his first nebulised dose of colistin [dose not clearly stated], he experienced mild breathing difficulty, but his condition improved over the following few hours. However, later that night after he inhaled his second dose of nebulised colistin, he experienced acute dyspnoea at rest with a breathing rate of 28 breaths/min, cyanosis and a low consciousness level. He was admitted to the ICU and was intubated for assisted ventilation. He also received IV corticosteroids. Subsequently, the man underwent a skin prick test with colistin but this was negative. He then underwent a desensitisation procedure and colistin tolerance was induced to 80mg nebulised at 30-minute intervals. He did not experience any changes in FEV1 and, at last follow-up, twice daily treatment with colistin was continuing with no new episodes of bronchospasm reported. Dominguez-Ortega J, et al. Induced tolerance to nebulized colistin after severe reaction to the drug. Journal of Investigational Allergology and Clinical 801078904 Immunology 17: 59-61, No. 1, 2007 - Spain
0114-9954/10/1160-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 14 Jul 2007 No. 1160
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