Safety of Nebulized Colistin Solution as Adjunctive Treatment of Lower Respiratory Tract Infections
| Autor: | Mitesh Patel, Mona Philips, Komal Nadeem, Mark Attalla, Karan Raja |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Respiratory tract infections
business.industry Colistin Neurotoxicity 030208 emergency & critical care medicine Drug resistance Pharmacology medicine.disease Kidney Nephrotoxicity Anti-Bacterial Agents Multiple drug resistance 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Creatinine Drug Resistance Multiple Bacterial Adjunctive treatment Medicine Humans Pharmacology (medical) business Respiratory Tract Infections medicine.drug |
| Zdroj: | Journal of pharmacy practice. 35(1) |
| ISSN: | 1531-1937 |
| Popis: | Background Systemic colistin is often utilized for management of drug resistant lower respiratory tract infections (LRTI). Nebulized administration of colistin allows direct instillation of active agent to maximize concentrations and limit systemic toxicities. Current literature supports efficacy of nebulized colistin as adjunctive treatment for LRTI. However, there is a paucity of data surrounding safety of this administration technique. Methods The electronic medical record (EMR) was queried to identify patients treated with nebulized colistin between January 1, 2016 and December 31, 2018. The data collected from the EMR and hospital adverse drug reaction (ADR) reporting systems included: demographics, dose, serum creatinine (SCr), concomitant nephrotoxins, infecting pathogen, treatment-emergent ADRs, and drug toxicities. The primary outcome was prevalence of renal, neurologic, or respiratory ADRs secondary to nebulized colistin. Results Thirty-two patients were administered nebulized colistin during the study period. Approximately 19% of patients had baseline chronic kidney disease. Cultures were positive in 29 patients of which 11 organisms were resistant to all tested antimicrobials. Three patients experienced acute kidney injury (AKI), 1 patient experienced a neurologic reaction, and 1 patient experienced a respiratory reaction, though none were considered treatment-related. Conclusion The results of our study signify localized administration of colistin results in a low incidence of systemic adverse events. Nebulized colistin is a safe adjunct for managing LRTI. |
| Databáze: | OpenAIRE |
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