TOXICITY OF COLISTIN IN CYSTIC-FIBROSIS PATIENTS
TOXICITY OF COLISTIN IN CYSTIC-FIBROSIS PATIENTS
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DOI：
10.1177/106002809102501101
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发表时间：
1991-11-01
期刊：
影响因子：
--
通讯作者：
HARRISON, GM
中科院分区：
文献类型：
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作者：
BOSSO, JA;LIPTAK, CA;HARRISON, GM
与铜绿假单胞菌菌株耐多种抗生素相关的囊性纤维化肺恶化正变得越来越普遍。寻找替代治疗方案的工作仍在继续，可能包括重新检查旧的抗生素。硫酸粘菌素是一种抗铜绿假单胞菌活性较好的多肽抗生素。尽管在20世纪70年代早期，由于经常出现肾脏和神经毒性的报道，它的使用在很大程度上已经停止，但静脉注射粘菌素经常在我们的机构用于铜绿假单胞菌对多种药物治疗耐药的患者。我们前瞻性监测19例患者在21个疗程的粘菌素治疗，以确定该药物的毒性特征和发生率。仅发生1例肾毒性。发生神经毒性6例，其特征为口周感觉异常、共济失调或两者兼而有之。在这些患者中，继发于粘菌素治疗的无法忍受的肾脏不良反应的发生率明显低于先前报道的其他患者。看来，静脉注射粘菌素可以考虑用于囊性纤维化患者的铜绿假单胞菌菌株耐更常用的抗生素。
Pulmonary exacerbations of cystic fibrosis associated with strains of Pseudomonas aeruginosa that are resistant to multiple antibiotics are becoming increasingly common. The search for treatment alternatives continues and may include the reexamination of older antibiotics. Colistin sulfate is a polypeptide antibiotic with good activity against P. aeruginosa. Although its use was largely discontinued in the early 1970s because of reports of frequent renal and neurologic toxicity, intravenous colistin is often prescribed at our institution for patients with P. aeruginosa resistant to multiple-drug therapy. We prospectively monitored 19 patients during 21 courses of colistin therapy to identify the character and incidence of this agent's toxicity. Only one case of renal toxicity occurred. Six cases of neurotoxicity occurred, which were characterized by perioral paresthesia, ataxia, or both. The rate of intolerable renal adverse effects secondary to colistin therapy was appreciably lower among these patients than that reported previously for other patients. It appears that intravenous colistin can be considered for cystic fibrosis patients with strains of P. aeruginosa that are resistant to more commonly used antibiotics.