Intravenous polymyxin B for the treatment of nosocomial pneumonia caused by multidrug-resistant Pseudomonas aeruginosa.
Nosocomial pneumonia caused by multidrug-resistant (MDR) Pseudomonas aeruginosa is becoming increasingly prevalent throughout the world. The use of polymyxins to treat these infections has greatly increased. We analysed 74 patients with nosocomial pneumonia caused by MDR P. aeruginosa who were treated with polymyxin B. A favourable outcome was observed in 35 patients (47.3%). A case-control study was performed to assess the variables associated with an unfavourable outcome. The presence of acute respiratory distress syndrome (odds ratio (OR)=11.29, 95% confidence interval (CI) 2.64-48.22; P=0.001) and septic shock (OR=4.81, 95% CI 1.42-16.25; P=0.01) were independently associated with an unfavourable outcome in patients with nosocomial pneumonia due to MDR P. aeruginosa. Our study demonstrated that polymyxin B is a reliable antimicrobial drug, but only as salvage therapy, for nosocomial pneumonia caused by MDR P. aeruginosa.
Furtado
Guilherme Henrique Campos
GH
Hospital Epidemiology Committee, Division of Infectious Diseases, Federal University of São Paulo, Brazil. ghfurtado@uol.com.br
d'Azevedo
Pedro Alves
PA
Santos
Anderson Fernandes
AF
Gales
Ana Cristina
AC
Pignatari
Antônio Carlos Campos
AC
Medeiros
Eduardo Alexandrino Servolo
EA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016022:Case-Control Studies; D003428:Cross Infection / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D011112:Polymyxin B / Q000008:administration & dosage / Q000627:therapeutic use*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D012307:Risk Factors; D012772:Shock, Septic / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D011112:Polymyxin B