Use of parenteral colistin for the treatment of serious infection due to antimicrobial-resistant Pseudomonas aeruginosa.
Serious infection due to strains of Pseudomonas aeruginosa that exhibit resistance to all common antipseudomonal antimicrobials increasingly is a serious problem. Colistin was used as salvage therapy for 23 critically ill patients with multidrug-resistant P. aeruginosa infection. Twenty-two patients who had septic shock (n=14) and/or renal failure (n=21) received mechanical ventilatory support at baseline. The most common types of infection were pneumonia (n=18) and intra-abdominal infection (n=5). Colistin was administered for a median of 17 days (range, 7-36 days). Seven patients died during therapy, at a median of 17 days (range, 4-26 days) after initiation of treatment. A favorable clinical response was observed in 14 patients (61%); only 3 patients experienced relapse. Bacteremia was the only significant factor associated with treatment failure (P=.02). One patient manifested diffuse weakness that resolved after temporary cessation of colistin therapy. Colistin provides an important salvage therapeutic option for patients with otherwise untreatable serious P. aeruginosa infection.
Linden
Peter K
PK
Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15261, USA. lindenpk@ccm.upmc.edu
Kusne
Shimon
S
Coley
Kim
K
Fontes
Paulo
P
Kramer
David J
DJ
Paterson
David
D
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003091:Colistin / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007362:Intensive Care Units; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa; D016879:Salvage Therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D003091:Colistin