To observe clinical curative effect and safety of intravenous drip and aerosol inhalation of colistimethate sodium for injection in patients with severe neurological disease and Acinetobacter baumannii (AB) pulmonary infection.

According to queuing method, patients with severe neurological disease and AB pulmonary infection in the hospital were divided into treatment group and control group. Control group was treated with colistimethate sodium for injection (150 mg bid, intravenous drip), while treatment group was treated with colistimethate sodium for injection (75 mg bid, aerosol inhalation) on basis of control group. All patients were treated for 5 days. The clinical curative effect, renal function, inflammatory response, bacterial clearance rates and prognosis in the two groups were compared, and the safety was evaluated.

Among the 80 patients, there were 40 cases in treatment group and 40 cases in control group. After treatment, total response rates of treatment group and control group were 72.50% (29 cases/40 cases) and 42.50% (17 cases/40 cases), levels of serum interleukin-8 were (4.07±1.01) and (5.01±1.65) pg·mL^-1, procalcitonin levels were 0.90(0.60, 1.35) and 1.50(1.05, 2.00) ng·mL^-1, C-reactive protein levels were (5.57±3.28) and (10.57±6.09) mg·L^-1, bacterial clearance rates were 60.00% (24 cases/40 cases) and 35.00% (14 cases/40 cases), and infection-related 28 d mortality rates were 5.00% (2 cases/40 cases) and 20.00% (8 cases/40 cases), the differences between the two groups were all statistically significant (all P<0.05). After treatment, levels of serum creatinine in treatment group and control group were (86.22±9.84) and (87.27±10.54) μmol·L^-1, and levels of blood urea nitrogen were (7.98±2.44) and (7.86±2.47) mmol·L^-1, the differences were not statistically significant (both P>0.05). The main adverse drug reactions in treatment group were rash, diarrhea and respiratory depression, while which in control group were rash and diarrhea. The difference in total incidence of adverse drug reactions between treatment group and control group was statistically significant (7.50% vs 5.00%, P>0.05).

Curative effect of intravenous drip combined with aerosol inhalation of polymyxin E is significant in patients with severe neurological disease and AB infection, which can effectively increase bacterial clearance rate, reduce inflammatory response and mortality, and will not increase renal injury.