Abstract

To the Editor: Respiratory tract infections due to viral, bacterial or even fungal pathogens are common after lung transplantation [1]. Previous studies demonstrated increased hospitalisation rates and a greater risk of chronic lung allograft dysfunction in colonised patients with cystic fibrosis (CF) [2]. Positive effects of inhaled antibiotics have been demonstrated for pneumonia in non-transplant patients with improvements of lung function, hospitalisation rates and need for i.v. antibiotics [3, 4]. Inhaled colistin is known to provide high drug concentrations in sputum while low systemic concentrations occur and treatment is well tolerated [5]. Here, the impact of inhaled colistin, both in reducing bacterial load in previously colonised patients and as a preventive therapy in non-colonised CF patients, after lung transplantation, was studied in a retrospective single-centre study (Hanover Medical School, Hanover, Germany). CF patients who underwent lung transplantation between January 1, 2005 and May 1, 2011 were included and follow-up continued until June 6, 2011. Perioperative antibiotics were continued for 2 weeks after lung transplantation, consisting of combination therapy based on previous microbiological findings. A routine surveillance programme at 1, 3, 6, 9 and 12 months after transplantation included pulmonary function testing, blood gas analysis and bronchoscopy with bronchoalveolar …

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