Colistin efficacy in the treatment of multidrug-resistant and extremely drug-resistant gram-negative bacterial infections


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ÇETİN Ç. B., Özer Türk D., Şenol Ş., Dinç Horasan G., Tünger Ö.

TURKISH JOURNAL OF MEDICAL SCIENCES, vol.46, no.5, pp.1379-1384, 2016 (SCI-Expanded, Scopus, TRDizin) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 46 Issue: 5
  • Publication Date: 2016
  • Doi Number: 10.3906/sag-1506-125
  • Journal Name: TURKISH JOURNAL OF MEDICAL SCIENCES
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.1379-1384
  • Keywords: Colistin, Efficacy, Extreme drug-resistance, Gram-negative bacteria, Multidrug-resistance, Nephrotoxicity
  • Open Archive Collection: AVESIS Open Access Collection
  • Manisa Celal Bayar University Affiliated: Yes

Abstract

Background/aim: Colistin is used as a salvage therapy for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections. Our aim was to evaluate colistin efficiency and toxicity in the treatment of these resistant gram-negative bacterial infections. Materials and methods: This is a retrospective study carried out in a tertiary care hospital during 2011-2013. Study data were collected from the medical records and consultations of the infectious diseases clinic. Results: The study group included 158 patients with nosocomial infections and 136 (86.1%) of them were hospitalized in the ICU. Respiratory tract infections were the most commonly observed ones (n = 103, 65.2%). The most frequently isolated microorganism was Acinetobacter baumannii (72.2%). A total of 98 (62.0%) patients had clinical cure. There was no statistically significant difference between monotherapy (n = 3/6, 50.0%) and combination therapies (n = 95/152, 62.5%) according to clinical response. Underlying ultimately fatal disease, previous renal disease, and total parenteral nutrition were independent risk factors for poor clinical response. Nephrotoxicity developed in 80 (50.6%) patients and clinical cure was statistically unrelated with nephrotoxicity. Conclusion: Colistin may be used as an effective agent for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections with close monitoring of renal functions, especially for older and critically ill patients.