Background Treatment with inhaled colistin (IC) in our health area has increased in recent years; requiring learning and retention by the patient.
Purpose To relate the adherence to treatment with IC with the efficacy in patients with non-cystic fibrosis bronchiectasis colonised with Pseudomonas aeruginosa (PA).
Material and methods Retrospective observational study in a university hospital between January 2010 and January 2014. We selected those patients who started treatment with IC during this period including those of whom we could monitor by obtaining data from the I-neb inhalation device. The information obtained was: average duration of the complete treatments, management of the device and the adherence of each patient for the first 3 months of continuous treatment. We obtained the demographic, diagnostic and microbiological data of each patient, considering in each case whether it was initial colonisation, intermittent or chronic.
Results Of 44 patients treated with IC, 19 of them met the study inclusion conditions as they could be monitored when visiting the Pharmacy Service with the I-neb device. The average age was 69.4 years (SD: 17.4) and 52.6% were women. Regarding the type of colonisation it was initial in 6 patients (31.6%), intermittent in 2 (10.5%) and chronic in 9 (47.4%). Only two patients had no culture and treatment was initiated empirically.
The data from the nebulization system were: 1. Complete treatment took on average 6.1 min (SD: 3.8), exceeding 10 min with only two patients. 2. 95.5% of patients used the device correctly. 3. Adherence to treatment was 93.9%, being less than 80% in one patient. After completion of the treatment, which lasted 3.5 months (SD: 2.2), cultures became negative in 9 patients (42.1%).
Conclusion Most of our patients were adherent to the treatment (73.7%) which suggests that the I-neb was easy to use.
The role of the pharmacist is relevant because in the few cases where the average length of complete treatments was higher or adherence was low, the importance of these concepts was reinforced during the monthly clinical interview.
References and/or acknowledgements No conflict of interest.
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