title: Use of parenteral colistin for the treatment of multiresistant Gram-negative organisms in major burn patients in South Korea.
abstract: OBJECTIVE
  To assess the therapeutic effect and toxicity of intravenous colistin in the treatment of multidrug-resistant (MDR) Gram-negative bacteria in patients with severe burns.
  
  
  METHODS
  The medical records of 930 patients admitted to the Burn Intensive Care Unit (ICU) at Hallym University Hangang Sacred Heart Hospital, Seoul, South Korea between April 2007 and December 2009 were retrospectively reviewed. Of these, the 104 patients who had received intravenous colistin treatments (104 courses) during this period were enrolled in the study. Changes in creatinine level were analyzed in three groups: all patients receiving colistin (n = 104), patients with undergoing continuous renal replacement therapy (CRRT group; n = 38), and patients not undergoing CRRT (non-CRRT group; n = 66).
  
  
  RESULTS
  Among these patients, the burnt body surface area ranged from 5 to 96% (mean 49.7%). Thirty-five patients (33.7%) suffered inhalation injury, and CRRT was administered to 38 patients. The mean duration of colistin treatment was 14.7 (range 4-71) days. The total dose of colistin was 3,045.7 mg (range 100-13,800). The length of ICU stay was 48.9 (range 7-154) days. Forty patients (38.5%) died. The mean pre-colistin creatinine level of all patients was 1.04 mg/dL, and the mean post-colistin level was 1.34 mg/dL. The mean pre-colistin creatinine level of the CRRT group and non-CRRT group was 1.68 and 0.66 mg/dL, and the mean post-colistin level was 1.68 and 1.14 mg/dL, respectively.
  
  
  CONCLUSIONS
  Colistin appears to be a relatively safe and effective treatment for major burn patients with infections caused by MDR Gram-negative bacteria when no other drug is available. Additionally, we found no statistically significant impairment of creatinine levels.
authors: Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 94-200 Youngdeungpo-dong, Youngdeungpo-gu, Seoul 150-719, Korea. maruchigs@hallym.or.kr
authors: Y S
authors: YS
authors: Cho
authors: H
authors: H
authors: Yim
authors: H T
authors: HT
authors: Yang
authors: J
authors: J
authors: Hur
authors: W
authors: W
authors: Chun
authors: J H
authors: JH
authors: Kim
authors: B C
authors: BC
authors: Lee
authors: D K
authors: DK
authors: Seo
authors: J M
authors: JM
authors: Park
authors: D
authors: D
authors: Kim
mesh_terms: D000150:Acinetobacter / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002053:Burn Units; D002056:Burns / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D002648:Child; D003091:Colistin / Q000008:administration & dosage / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011549:Pseudomonas / Q000302:isolation & purification; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D017582:Renal Replacement Therapy; D056910:Republic of Korea; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003404:Creatinine; D003091:Colistin