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, cilt.46, sa.5, ss.1379-1384, 2016 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 46 Sayı: 5
  • Basım Tarihi: 2016
  • Doi Numarası: 10.3906/sag-1506-125
  • Dergi Adı: Turkish Journal of Medical Sciences
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.1379-1384
  • Anahtar Kelimeler: Colistin, Efficacy, Extreme drug-resistance, Gram-negative bacteria, Multidrug-resistance, Nephrotoxicity
  • Manisa Celal Bayar Üniversitesi Adresli: Evet

Özet

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.