Effectiveness and nephrotoxicity of intravenous colistin for treatment of patients with infections due to polymyxin-only-susceptible (POS) gram-negative bacteria
Effectiveness and nephrotoxicity of intravenous colistin for treatment of patients with infections due to polymyxin-only-susceptible (POS) gram-negative bacteria
复制标题
DOI：
10.1007/s10096-006-0191-2
复制
发表时间：
2006-09-01
影响因子：
4.5
通讯作者：
Samonis, G.
中科院分区：
文献类型：
--
作者：
Falagas, M. E.;Kasiakou, S. K.;Samonis, G.
本前瞻性病例系列研究旨在评估静脉注射粘菌素治疗多粘菌素敏感（POS）革兰氏阴性菌感染患者的结局。在2003年7月至2005年4月期间，共有27名患者感染POS革兰氏阴性菌，并接受静脉注射粘菌素，剂量为200万国际单位（MIU）（160 mg或66.7 mg粘菌素碱），每8小时一次，平均（+/- SD）持续时间为13.9（+/- 7.5）天。9例患者患有呼吸机相关性肺炎，除静脉注射粘菌素治疗外，还接受了1 MIU（80 mg或33.3 mg粘菌素碱）雾化粘菌素，每12小时一次，平均（+/- SD）持续时间为13（+/- 6.5）天。主要病原体为铜绿假单胞菌（n=17）和鲍曼不动杆菌（n=12）;在2例患者中，两种病原体均分离自1份临床标本。住院死亡率和临床反应分别为15%和85%。在27例患者中的2例中观察到粘菌素相关的肾毒性。POS革兰氏阴性病原体是住院患者的主要威胁。粘菌素似乎是一种有效和安全的治疗方法，即使在有严重基础疾病的患者中也是如此。
The prospective case series study presented here was conducted to assess the outcome of patients with infections caused by polymyxin-only-susceptible (POS) gram-negative bacteria managed with intravenous colistin. Between July 2003 and April 2005 a total of 27 patients were infected with a POS gram-negative bacterium and received intravenous colistin at a dose of 2 million international units (MIU) (160 mg or 66.7 mg colistin base) every 8 h for a mean (+/- SD) duration of 13.9 (+/- 7.5) days. Nine patients had ventilator-associated pneumonia and received, in addition to the intravenous colistin therapy, 1 MIU (80 mg or 33.3 mg colistin base) aerosolized colistin every 12 h for a mean (+/- SD) duration of 13 (+/- 6.5) days. The predominant pathogens were Pseudomonas aeruginosa (n=17) and Acinetobacter baumannii (n=12); in two patients both pathogens were isolated from one clinical specimen. In-hospital mortality and clinical response were 15% and 85%, respectively. Colistin-associated nephrotoxicity was observed in two of the 27 patients. POS gram-negative pathogens represent a major threat for hospitalized patients. Colistin appears to be an effective and safe treatment, even in patients with severe underlying diseases.