title: Intravenous polymyxin B for the treatment of nosocomial pneumonia caused by multidrug-resistant Pseudomonas aeruginosa.
abstract: 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.
authors.affiliation: Hospital Epidemiology Committee, Division of Infectious Diseases, Federal University of São Paulo, Brazil. ghfurtado@uol.com.br
authors.forename: Guilherme Henrique Campos
authors.initials: GH
authors.lastname: Furtado
authors.forename: Pedro Alves
authors.initials: PA
authors.lastname: d'Azevedo
authors.forename: Anderson Fernandes
authors.initials: AF
authors.lastname: Santos
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Gales
authors.forename: Antônio Carlos Campos
authors.initials: AC
authors.lastname: Pignatari
authors.forename: Eduardo Alexandrino Servolo
authors.initials: EA
authors.lastname: Medeiros
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D011112:Polymyxin B