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Diagnosing DIRD
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The Drug-Induced Respiratory Disease Website
Philippe Camus, M.D.
Dijon, France
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Drugs
Patterns
Colistin, inhaled
3
Last update :
02/01/2020
I - Interstitial/parenchymal lung disease
I.c
Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)
1
IV - Airway involvement
IV.a
Bronchospasm - Wheezing - Asthma
2
IV.f
Severe or catastrophic bronchospasm or asthma attack (can be fatal)
1
IV.aa
Occupational asthma
1
IX - Neuromuscular / CNS involvement - Disordered breathing during sleep
IX.d
Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)
1
XI - Miscellaneous
XI.u
Chest pressure/discomfort
3
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Colistin-Colimycin