title: Colistin efficacy in the treatment of multidrug-resistant and extremelydrug-resistant gram-negative bacterial infections.
abstract: OBJECTIVE
  Colistin is used as a salvage therapy for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections. Our aim was to evaluate colistin efficiency and toxicity in the treatment of these resistant gram-negative bacterial infections.
  
  
  METHODS
  This is a retrospective study carried out in a tertiary care hospital during 2011-2013. Study data were collected from the medical records and consultations of the infectious diseases clinic.
  
  
  RESULTS
  The study group included 158 patients with nosocomial infections and 136 (86.1%) of them were hospitalized in the ICU. Respiratory tract infections were the most commonly observed ones (n = 103, 65.2%). The most frequently isolated microorganism was Acinetobacter baumannii (72.2%). A total of 98 (62.0%) patients had clinical cure. There was no statistically significant difference between monotherapy (n = 3/6, 50.0%) and combination therapies (n = 95/152, 62.5%) according to clinical response. Underlying ultimately fatal disease, previous renal disease, and total parenteral nutrition were independent risk factors for poor clinical response. Nephrotoxicity developed in 80 (50.6%) patients and clinical cure was statistically unrelated with nephrotoxicity.
  
  
  CONCLUSIONS
  Colistin may be used as an effective agent for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections with close monitoring of renal functions, especially for older and critically ill patients.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Celal Bayar University Manisa, Turkey.
authors.forename: Çiğdem Banu
authors.initials: ÇB
authors.lastname: Çetin
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Celal Bayar University Manisa, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Özer Türk
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Celal Bayar University Manisa, Turkey.
authors.forename: Şebnem
authors.initials: Ş
authors.lastname: Şenol
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Gönül
authors.initials: G
authors.lastname: Dinç Horasan
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Celal Bayar University Manisa, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Tünger
mesh_terms: D040981:Acinetobacter baumannii; D000900:Anti-Bacterial Agents; D003091:Colistin; D024901:Drug Resistance, Multiple, Bacterial; D016905:Gram-Negative Bacterial Infections; D006801:Humans; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin
keywords: Colistin; efficacy; extreme drug-resistance; gram-negative bacteria; multidrug-resistance; nephrotoxicity