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Comparisons of Colistin-Induced Nephrotoxicity Between Two Different Formulations of Colistin in Critically Ill Patients: A Retrospective Cohort Study
- Source :
- Antimicrobial Resistance and Infection Control, Antimicrobial Resistance and Infection Control, Vol 10, Iss 1, Pp 1-12 (2021)
- Publication Year :
- 2021
- Publisher :
- Research Square Platform LLC, 2021.
-
Abstract
- Background Colistin is widely used in the treatment of nosocomial infections caused by carbapenem-resistant gram-negative bacilli (CR-GNB). Colistin-induced nephrotoxicity is one of the major adverse reactions during colistin treatment. Comparisons of colistin-induced nephrotoxicity between different formulations of colistin are rarely reported. Methods In this retrospective cohort study, we enrolled intensive care unit–admitted patients if they had culture isolates of CR-GNB and underwent intravenous treatment with colistin. The occurrence of acute kidney injury (AKI) during intravenous treatment with colistin was recorded. The occurrence of colistin-induced nephrotoxicity was compared between two formulations of colistin, Locolin®, and Colimycin®. Treatment outcomes associated with the occurrence of colistin-induced nephrotoxicity were also investigated. Results Among 195 patients, 95 who were treated with Locolin® and 100 who were treated with Colimycin® were included for analysis. Patients treated with Locolin® had a higher rate of occurrence of stage 2 (46.3% vs. 32%, p = 0.040) and stage 3 (29.5% vs. 13%, p = 0.005) AKI than did those treated with Colimycin®. In multivariate analysis, the presence of septic shock (adjusted odds ratio [aOR] 2.17, 95% confidence interval [CI] 1.10–4.26) and inappropriate colistin dosage (aOR 2.52, 95% CI 1.00–6.33) were clinical factors associated with colistin-induced nephrotoxicity. Treatment with Colimycin® was an independent factor associated with a lower risk of colistin-induced nephrotoxicity (aOR 0.37, 95% CI 0.18–0.77). The mortality rate was comparable between patients with and without colistin-induced nephrotoxicity. Conclusions The risk of colistin-induced nephrotoxicity significantly varied in different formulations of colistin in critically ill patients. Colistin-induced nephrotoxicity was not associated with increased mortality rate.
- Subjects :
- Male
0301 basic medicine
Infectious and parasitic diseases
RC109-216
0302 clinical medicine
Risk Factors
polycyclic compounds
Medicine
Pharmacology (medical)
Hospital Mortality
030212 general & internal medicine
Nephrotoxicity
Aged, 80 and over
Acute kidney injury
Acute Kidney Injury
Middle Aged
Infectious Diseases
Administration, Intravenous
Female
lipids (amino acids, peptides, and proteins)
medicine.drug
Microbiology (medical)
medicine.medical_specialty
Critical Illness
Drug Compounding
030106 microbiology
Taiwan
Lower risk
03 medical and health sciences
Intensive care
Internal medicine
Drug Resistance, Bacterial
Humans
Mortality
Aged
Retrospective Studies
Colistin
business.industry
Septic shock
Research
Public Health, Environmental and Occupational Health
Retrospective cohort study
Odds ratio
biochemical phenomena, metabolism, and nutrition
medicine.disease
bacterial infections and mycoses
Formulation
bacteria
business
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Antimicrobial Resistance and Infection Control, Antimicrobial Resistance and Infection Control, Vol 10, Iss 1, Pp 1-12 (2021)
- Accession number :
- edsair.doi.dedup.....e5922da9cd8f4ace4ffb8a01bd4d1ac7