title: The efficacy and nephrotoxicity associated with colistin use in an intensive care unit in Vietnam: Use of colistin in a population of lower body weight.
abstract: BACKGROUND
  There has been a growing need for colistin as a key drug for the treatment of MDR-GNB infection. Information on colistin use in Asian population is limited.
  
  
  METHODS
  A retrospective observational study was conducted to assess the efficacy and nephrotoxicity in critically ill adult patients who received intravenous colistin for MDR-GNB infection in the intensive care unit (ICU) at Bach Mai Hospital in Hanoi, Vietnam. Colistin was administered according to the dosing guideline that was based on pharmacokinetic, pharmacodynamic and toxicodynamic principles, adjusted by body weight and creatinine clearance.
  
  
  RESULTS
  Twenty-eight eligible patients were included. The mean patient age was 60±20.4 years. The mean body weight was 53±8.6kg. The mean daily dose of colistin was 4.1±1.6 MIU, and the mean cumulative dose of colistin was 48.2±22.8 MIU. Colistin therapies were classified as clinically effective in 19 (67.9%) cases. Six (21.4%) patients developed nephrotoxicity during the study period according to RIFLE criteria.
  
  
  CONCLUSIONS
  A personalized dosing protocol of colistin was effective, with low nephrotoxicity, among critically ill Vietnamese patients with low body weight. Further studies are warranted for assessing the efficacy and toxicity in a larger cohort.
authors.affiliation: Intensive Care Unit of Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Nguyen Gia
authors.initials: NG
authors.lastname: Binh
authors.affiliation: Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: kayokohayakawa@gmail.com.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Hayakawa
authors.affiliation: Intensive Care Unit of Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Dao Xuan
authors.initials: DX
authors.lastname: Co
authors.affiliation: Intensive Care Unit of Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Nguyen Dang
authors.initials: ND
authors.lastname: Tuan
authors.affiliation: Hanoi University of Pharmacy, Hanoi, Vietnam.
authors.forename: Nguyen Hoang
authors.initials: NH
authors.lastname: Anh
authors.affiliation: Pharmacy department of Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Nguyen Thi Hong
authors.initials: NT
authors.lastname: Thuy
authors.affiliation: Microbiology Department of Bach Mai hospital, Hanoi, Vietnam.
authors.forename: Doan Mai
authors.initials: DM
authors.lastname: Phuong
authors.affiliation: Hanoi University of Pharmacy, Hanoi, Vietnam.
authors.forename: Nguyen Thi Lien
authors.initials: NT
authors.lastname: Huong
authors.affiliation: National Center for Global Health and Medicine - Bach Mai hospital Medical Collaboration Center.
authors.forename: Pham Thi Phuong
authors.initials: PT
authors.lastname: Thuy
authors.affiliation: Respiratory Department, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Ngo Qui
authors.initials: NQ
authors.lastname: Chau
authors.affiliation: Microbiology Department of Bach Mai hospital, Hanoi, Vietnam.
authors.forename: Pham Hong
authors.initials: PH
authors.lastname: Nhung
authors.affiliation: Pharmacy department of Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Do Thi Hong
authors.initials: do TH
authors.lastname: Gam
authors.affiliation: Pharmacy department of Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Duong Thanh
authors.initials: DT
authors.lastname: Hai
authors.affiliation: Pharmacy department of Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Tran Thu
authors.initials: TT
authors.lastname: Huong
authors.affiliation: Pharmacy department of Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Le
authors.initials: L
authors.lastname: Van Anh
authors.affiliation: Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Takeshita
authors.affiliation: Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Ohmagari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003091:Colistin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013851:Thinness; D014744:Vietnam; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin
keywords: Asia; Colistin; Hospital acquired infection; ICU; Lower body weight; Nephrotoxicity