Clinical Efficacy and Safety of Colistin Sulfate in the Treatment of Carbapenem-Resistant Organism Infections in Patients with Hematological Diseases

• Published in: Infectious diseases and therapy Vol. 13; no. 1; pp. 141 - 154
• Main Authors: Wu, Yuanbing, Jiang, Shanshan, Li, Dongyang, Wu, Yaxue, Li, Qian, Wang, Xing, Liu, Bin, Bao, Haiyan, Wu, Depei, Hu, Xiaohui
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 2024; Springer; Springer Nature B.V; Adis, Springer Healthcare
• Subjects: Antibiotics; Antimicrobial agents; Carbapenem-resistant organisms; Care and treatment; China; Colistin; Health aspects; Hematological diseases; Hematology; Infection; Infection control; Infections; Infectious Diseases; Internal Medicine; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Mortality; Neurotoxicity; Original Research; Polymyxins; Safety; Sulfates; China; Carbapenem-resistant organisms; Infections; Colistin; Hematological diseases; Polymyxins
• ISSN: 2193-8229; 2193-6382
• DOI: 10.1007/s40121-023-00909-8

Introduction Carbapenem-resistant organisms (CRO) have emerged as a significant worldwide issue. However, the availability of efficacious antibiotics for treating CRO infections remains limited. Polymyxins, including colistin sulfate, represent the last-line therapeutic option against CRO infections. This study aims to retrospectively evaluate the clinical effectiveness and safety of colistin sulfate in managing CRO infections among patients with hematological diseases. Methods Between April 2022 and January 2023, a total of 118 hematological patients diagnosed with CRO infection were treated with colistin sulfate at Suzhou Hongci Hospital of Hematology. The assessment encompassed the clinical efficacy, bacterial clearance rate, adverse reactions, and 30-day all-cause mortality. Results The study found that the total effective rate of colistin sulfate in the treatment of CRO infection was 74.6%, with a bacterial clearance rate of 72.6%. Throughout the treatment, nephrotoxicity occurred in 7.6% of cases, neurotoxicity in 2.5% of cases, and the 30-day all-cause mortality rate was 22.9%. Multivariate logistic analysis revealed that the treatment course and combination medication with other antimicrobials were independent factors affecting the clinical efficacy of colistin sulfate. Conclusion Our study demonstrates that the treatment of colistin sulfate can achieve high clinical efficacy and microbial responses, with a low risk of nephrotoxicity. This study provides evidence of the positive clinical efficacy and safety of colistin sulfate treatment in these patients. High-quality randomized controlled trials are still needed to further confirm the beneficial role of colistin sulfate.