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Research Article Free access | 10.1172/JCI107490

Prevention of Gram-Negative Bacillary Pneumonia Using Aerosol Polymyxin as Prophylaxis. I. EFFECT ON THE COLONIZATION PATTERN OF THE UPPER RESPIRATORY TRACT OF SERIOUSLY ILL PATIENTS

Sheldon Greenfield, Daniel Teres, Leonard S. Bushnell, John Hedley-Whyte, and David S. Feingold

Department of Medicine of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Department of Anaesthesia of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Infectious Disease Unit, Beth Israel-Children's Hospital Medical Center, Boston, Massachusetts 02215

Find articles by Greenfield, S. in: PubMed | Google Scholar

Department of Medicine of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Department of Anaesthesia of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Infectious Disease Unit, Beth Israel-Children's Hospital Medical Center, Boston, Massachusetts 02215

Find articles by Teres, D. in: PubMed | Google Scholar

Department of Medicine of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Department of Anaesthesia of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Infectious Disease Unit, Beth Israel-Children's Hospital Medical Center, Boston, Massachusetts 02215

Find articles by Bushnell, L. in: PubMed | Google Scholar

Department of Medicine of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Department of Anaesthesia of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Infectious Disease Unit, Beth Israel-Children's Hospital Medical Center, Boston, Massachusetts 02215

Find articles by Hedley-Whyte, J. in: PubMed | Google Scholar

Department of Medicine of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Department of Anaesthesia of the Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts 02215

Infectious Disease Unit, Beth Israel-Children's Hospital Medical Center, Boston, Massachusetts 02215

Find articles by Feingold, D. in: PubMed | Google Scholar

Published November 1, 1973 - More info

Published in Volume 52, Issue 11 on November 1, 1973
J Clin Invest. 1973;52(11):2935–2940. https://doi.org/10.1172/JCI107490.
© 1973 The American Society for Clinical Investigation
Published November 1, 1973 - Version history
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Abstract

A prospective study used polymyxin B by aerosol to reduce colonization of the upper respiratory tract with nosocomial gram-negative bacilli. 58 high-risk patients from the Respiratory-Surgical Intensive Care Unit entered the trial. 33 were randomly selected to receive 2.5 mg/kg/day of polymyxin B by hand atomizer into the pharynx, and tracheal tube if present. 17 of 25 control patients became colonized with gram-negative bacilli as compared with 7 of 33 polymyxin-treated patients (p < 0.01). Control patients became colonized with a total of 33 gram-negative bacilli: 3 were Pseudomonas aeruginosa, 21 were species of Enterobacteriaceae. The polymyxin-treated patients became colonized with a total of 11 gram-negative bacilli: no P. aeruginosa and only 3 species of Enterobacteriaceae were recovered. Colonization increased with duration in Respiratory-Surgical Intensive Care Unit and with time of required controlled ventilation. Polymyxin most effectively prevented the increase in colonization in treated patients who stayed in the Respiratory-Surgical Intensive Care Unit for longer than 1 wk and who required controlled ventilation for at least 72 h.

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