INTRODUCTION:There is very limited evidence concerning phenytoin-related mydriasis.CASE REPORT:A 59-year-old male was hospitalized in the intensive care unit due to a head injury. During his hospitalization, phenytoin was administrated. Some days later he presented bilateral mydriasis.  At that time he had impaired creatinine clearance 7 ml/min, albumin levels 3.4 gr/dl, and phenytoin serum concentration 19.94 μg/dl. Evaluation with brain computed tomography and magnetic resonance imaging did not reveal any potential cause of mydriasis, while none of the co-administrated drugs have been reported to cause significant mydriasis. After initiation of continuous venovenous hemodiafiltration and discontinuation of phenytoin, mydriasis was reversed.CONCLUSION:Clinicians should be aware that mydriasis due to a toxic concentration of phenytoin may be manifested. Hippokratia 2016, 20(2): 166-168.

Although inhaled colistin is frequently used in ventilator-associated pneumonia (VAP), data regarding its pharmacokinetic properties are scarce [1-3]. The aim of this study was to describe colistin pharmacokinetics in critically ill patients after administration of a single dose of 1 million units of colistimethate sodium (CMS) via nebulization.

Limited evidence exists regarding the efficacy of inhaled antibiotics in ventilator-associated tracheobronchitis (VAT) [1,2]. The aim of this study was to assess the effect of monotherapy with nebulized colistin on clinical and microbiological outcomes in critically ill patients with VAT due to polymyxin-only susceptible Gram-negative bacteria.