Ten years with colistin: a retrospective case series
| Autor: | David E. Katz, D. Marchaim, Amos M. Yinnon, Yonit Wiener-Well, Marc V. Assous, Eli Ben-Chetrit |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine Pediatrics medicine.medical_specialty medicine.medical_treatment 030106 microbiology Renal function Microbial Sensitivity Tests Urine Nephrotoxicity 03 medical and health sciences chemistry.chemical_compound Drug Resistance Bacterial medicine Humans Respiratory Tract Infections health care economics and organizations Dialysis Retrospective Studies Aged 80 and over Cross Infection Creatinine Colistin business.industry Incidence (epidemiology) General Medicine Anti-Bacterial Agents Community-Acquired Infections Hospitalization Defined daily dose chemistry Urinary Tract Infections Female Gram-Negative Bacterial Infections business medicine.drug |
| Zdroj: | International Journal of Clinical Practice. 70:706-711 |
| ISSN: | 1368-5031 |
| DOI: | 10.1111/ijcp.12830 |
| Popis: | Summary Objective At the Shaare Zedek Medical Center, we have been using colistimethate sodium (CMS) for empiric as well as pathogen-directed treatment. We present our 10-year experience. Methods We conducted a retrospective case-series analysis of patients admitted from 1 January 2004 through 1 May 2014 who received at least one dose of CMS. Patient characteristics analysed for all admission for which patients received CMS, included: age, number of re-admissions, admission ward, renal function, disposition and microbiology results. Overall trend in defined daily dose (DDD) for CMS and resistant isolates was analysed. Results A total of 5603 admissions met inclusion criteria. Patients' mean (±SD) age was 80 ± 14 years, 1162 (48%) of the admissions were from a healthcare facility and 4367 (78%) of the admissions were to general Internal Medicine wards. The median number of hospital admissions per patient was 5, median admission and discharge creatinine (mg/dl) were 1.05 and 1.01, respectively; 2.3% of admissions required first-time dialysis. The discharge rate from the hospital was 58.4%. Excluding intrinsically CMS-resistant gram-negative organisms, bloodstream and urine isolates were 98% and 100% susceptible, respectively. CMS use (DDDs) increased during the study (p for trend = 0.04) without significant increase in incidence of multidrug-resistant organisms. Conclusions Colistimethate sodium use at our institution has increased during this 10-year period. Nevertheless, there is no increasing trend in CMS-resistant organisms, 58% of the patients were discharged alive, and we did not observe significant nephrotoxicity in patients prescribed CMS. CMS should be reserved for microbiologically confirmed extensively drug-resistant gram-negative infections. |
| Databáze: | OpenAIRE |
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