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


CONCLUSIONS
Colistin was used in 80 patients infected with A. baumannii or P. aeruginosa and appeared to be efficacious and safe.
Berlana
David
D
Pharmacy Service, Hospital Universitari de Bellvitge, Barcelona, Spain. dberlana@hosppal.es
Llop
J M
JM
Fort
E
E
Badia
M B
MB
Jódar
R
R
D000151:Acinetobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D003091:Colistin / Q000494:pharmacology / Q000627:therapeutic use*; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome
D003091:Colistin