Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients.
Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients.
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DOI：
10.1186/cc2358
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发表时间：
2003-10
期刊：
影响因子：
--
通讯作者：
Gregorakos L
中科院分区：
文献类型：
--
作者：
Markou N;Apostolakos H;Koumoudiou C;Athanasiou M;Koutsoukou A;Alamanos I;Gregorakos L
多重耐药革兰氏阴性菌株在重症监护病房（ICU）中的日益普遍，最近重新点燃了对粘菌素的兴趣，粘菌素是一种杀菌抗生素，在20世纪60年代用于治疗革兰氏阴性杆菌引起的感染。我们进行了目前的观察性研究，以评估静脉注射粘菌素在治疗革兰氏阴性杆菌对所有其他抗生素耐药引起的脓毒症危重患者中的疗效。革兰氏阴性杆菌对除粘菌素外的所有抗生素都耐药，导致脓毒症的危重患者在创伤医院的6张病床ICU中接受治疗。感染的诊断基于临床数据和细菌分离，并测试细菌对粘菌素的敏感性。评价了对粘菌素的临床反应。24例患者（平均年龄44.3岁，平均急性生理学和慢性健康评估II评分20.6）接受了26个疗程的粘菌素治疗。73%的治疗观察到临床反应。30天生存率为57.7%。在21例尚未接受肾脏替代治疗的患者中，14.3%的患者观察到肾功能恶化，但仅1例患者的肾功能恶化导致严重临床后果。由于本研究中缺乏对照组，因此无法得出关于粘菌素临床有效性的任何明确结论。另一方面，这种药物具有可接受的安全性，应考虑在多重耐药革兰阴性杆菌的严重感染中使用。
The increasing prevalence of multiresistant Gram-negative strains in intensive care units (ICUs) has recently rekindled interest in colistin, a bactericidal antibiotic that was used in the 1960s for treatment of infections caused by Gram-negative bacilli. We conducted the present observational study to evaluate the efficacy of intravenous colistin in the treatment of critically ill patients with sepsis caused by Gram-negative bacilli resistant to all other antibiotics. Critically ill patients with sepsis caused by Gram-negative bacilli resistant to all antibiotics with the exception of colistin were treated in the six-bed ICU of a trauma hospital. Diagnosis of infection was based on clinical data and isolation of bacteria, and the bacteria were tested with respect to their susceptibility to colistin. Clinical response to colistin was evaluated. Twenty-four patients (mean age 44.3 years, mean Acute Physiology and Chronic Health Evaluation II score 20.6) received 26 courses of colistin. Clinical response was observed for 73% of the treatments. Survival at 30 days was 57.7%. Deterioration in renal function was observed in 14.3% of 21 patients who were not already receiving renal replacement therapy, but in only one case did this deterioration have serious clinical consequences. The lack of a control group in the present study does not allow any definite conclusions to be drawn regarding the clinical effectiveness of colistin. On the other hand, this drug has an acceptable safety profile and its use should be considered in severe infections with multiresistant Gram-negative bacilli.
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DOI：
10.1177/106002809102501101
发表时间：
1991-11-01
期刊：
DICP-THE ANNALS OF PHARMACOTHERAPY
影响因子：
--
作者：
BOSSO, JA;LIPTAK, CA;HARRISON, GM
通讯作者：
HARRISON, GM
影响因子：
5.2
作者：
Catchpole, CR;Andrews, JM;Wise, R
通讯作者：
Wise, R
影响因子：
6.5
作者：
Prentice, HG;Hann, IM;Kibbler, CC
通讯作者：
Kibbler, CC
影响因子：
5.2
作者：
Henwood, CJ;Gatward, T;Woodford, N
通讯作者：
Woodford, N
影响因子：
9.6
作者：
Kollef, MH;Ward, S
通讯作者：
Ward, S