Colistin as a salvage therapy for nosocomial infections caused by multidrug-resistant bacteria in the ICU

• Published in: International journal of antimicrobial agents Vol. 28; no. 4; pp. 366 - 369
• Main Authors: Kallel, Hatem, Bahloul, Mabrouk, Hergafi, Leila, Akrout, Malek, Ketata, Wajdi, Chelly, Hedi, Hamida, Chokri Ben, Rekik, Noureddine, Hammami, Adnane, Bouaziz, Mounir
• Format: Journal Article
• Language: English
• Published: London Elsevier B.V 01.10.2006; Amsterdam Elsevier; New York, NY
• Subjects: Acinetobacter baumannii; Acinetobacter Infections - drug therapy; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Colistin; Colistin - administration & dosage; Colistin - therapeutic use; Cross Infection - drug therapy; Drug Resistance, Multiple, Bacterial; Humans; Intensive Care Units; Medical sciences; Multidrug resistance; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Nosocomial infection; Pharmacology. Drug treatments; Prospective Studies; Pseudomonas aeruginosa; Pseudomonas Infections - drug therapy; Renal failure; Salvage Therapy; Treatment Outcome; Nosocomial infection; Colistin; Multidrug resistance; Renal failure; Kidney disease; Treatment resistance; Urinary system disease; Cyclic peptides; Intensive care unit; Antibiotic; Polypeptide; Multiple resistance; Bacteria; Salvage treatment; Antibacterial agent
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2006.07.008

The objective of this study was to determine the efficacy of systemic colistin therapy in the treatment of nosocomial infections caused by multidrug-resistant Acinetobacter baumannii or Pseudomonas aeruginosa and to study related adverse events. We prospectively studied 78 infections caused by multidrug-resistant A. baumannii or P. aeruginosa that were treated with colistin. The sites of infection were pulmonary infection (78.2%), urinary tract infection (7.7%), primary bloodstream infection (11.5%) and meningitis (2.6%). The mean daily dose of colistin was 5.5 ± 1.1 MU/day (range 2–9 MU/day) and the mean duration of colistin therapy was 9.3 ± 3.8 days (range 5–21 days). A favourable clinical response to colistin occurred in 60 cases (76.9%). Renal failure occurred in only seven cases. We conclude that colistin can be a safe and effective salvage therapeutic option for nosocomial infections caused by multidrug-resistant A. baumannii or P. aeruginosa.