Use of colistin in the treatment of multiple-drug-resistant gram-negative infections

Am J Health Syst Pharm. 2005 Jan 1;62(1):39-47. doi: 10.1093/ajhp/62.1.39.

Abstract

Purpose: The use of colistin for the treatment of infections caused by multiple-drug-resistant (MDR) gram-negative microorganisms was studied.

Methods: The efficacy of colistin for treating infections caused by MDR gram-negative microorganisms and the development of renal toxicity were studied in hospitalized adult patients in Spain. Patients treated between January 2001 and October 2001 were included.

Results: Over the study period, 71 courses of inhaled colistin, 12 courses of i.v. or intramuscular (i.m.) colistin, and 2 courses of intrathecal colistin were administered to 80 patients. All were infected by MDR organisms: 69 (86%) by Acinetobacter baumannii and 11 (14%) by Pseudomonas aeruginosa. In 41 patients (51%), the episodes were caused by A. baumannii strains susceptible exclusively to colistin. The causative organisms were cleared in 92% of the patients from whom posttreatment repeat specimens were obtained. The in-hospital mortality rate was 18% (14 patients). There were no significant changes in mean serum urea or creatinine concentrations in patients receiving i.v. or i.m. therapy.

Conclusion: Colistin was used in 80 patients infected with A. baumannii or P. aeruginosa and appeared to be efficacious and safe.

Publication types

  • Comparative Study

MeSH terms

  • Acinetobacter Infections / diagnosis
  • Acinetobacter Infections / drug therapy*
  • Colistin / pharmacology
  • Colistin / therapeutic use*
  • Drug Administration Routes
  • Drug Administration Schedule
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Inpatients
  • Length of Stay
  • Male
  • Middle Aged
  • Pseudomonas Infections / diagnosis
  • Pseudomonas Infections / drug therapy*
  • Retrospective Studies
  • Spain
  • Treatment Outcome

Substances

  • Colistin