https://scholars.lib.ntu.edu.tw/handle/123456789/535932
標題: | Safety and efficacy of intravenous colistin (colistin methanesulphonate) for severe multidrug-resistant Gram-negative bacterial infections | 作者: | Cheng C.-Y. WANG-HUEI SHENG JANN-TAY WANG YEE-CHUN CHEN SHAN-CHWEN CHANG |
公開日期: | 2010 | 卷: | 35 | 期: | 3 | 起(迄)頁: | 297-300 | 來源出版物: | International Journal of Antimicrobial Agents | 摘要: | Multidrug-resistant (MDR) bacterial infections are increasing in Taiwan hospitals, prompting the common use of colistin. In this study, the safety and efficacy of intravenous (i.v.) colistin was assessed. The medical records of patients receiving colistin for treatment of MDR Gram-negative bacterial infections between January 2006 and September 2008 at a Taiwan medical centre were reviewed retrospectively. Demographics, clinical presentation, causative organism, adverse events and outcomes were recorded. Of the 115 patient records analysed, 74 patients (64%) were treated in the Intensive Care Unit. Common underlying diseases were hypertension (49%), chronic pulmonary disease (46%), chronic kidney disease (33%) and malignancy (31%). Lower respiratory tract infections were most common (71%), followed by primary bloodstream infections (12%), urinary tract infections (8.7%) and others (7.8%). Successful treatment with i.v. colistin against MDR Gram-negative bacterial infections occurred in 59 patients (51%). Multivariate analysis showed that a higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (odds ratio = 1.14; 95% confidence interval 1.02-1.28; P = 0.02) was independently associated with a poor clinical response. Overall, 12 (14%) of 84 patients presented nephrotoxicity and 4 patients (3.5%) had neurotoxicity. In conclusion, colistin is an effective antimicrobial agent for severe infections caused by MDR Gram-negative bacteria. Clinical outcomes are associated with the severity of infection and underlying diseases. Compared with previous reports, this study showed a lower incidence of nephrotoxicity and neurotoxicity. ? 2009 Elsevier B.V. and the International Society of Chemotherapy. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-73549097280&doi=10.1016%2fj.ijantimicag.2009.11.016&partnerID=40&md5=a701dc085105133946f4953d9b7df72d https://scholars.lib.ntu.edu.tw/handle/123456789/535932 |
ISSN: | 0924-8579 | DOI: | 10.1016/j.ijantimicag.2009.11.016 | SDG/關鍵字: | amikacin; cefepime; ceftazidime; cilastatin plus imipenem; colistimethate; levofloxacin; sultamicillin; Acinetobacter baumannii; aged; APACHE; article; bloodstream infection; chronic kidney disease; chronic lung disease; clinical feature; controlled study; demography; disease severity; drug efficacy; drug response; drug safety; drug withdrawal; female; focal epilepsy; Gram negative infection; human; hypertension; intensive care unit; lower respiratory tract infection; major clinical study; male; malignant neoplastic disease; medical record review; mental disease; multidrug resistance; nephrotoxicity; neurotoxicity; outcome assessment; priority journal; Pseudomonas aeruginosa; risk benefit analysis; Taiwan; treatment duration; urinary tract infection; Aged; Aged, 80 and over; Anti-Bacterial Agents; Central Nervous System; Central Nervous System Diseases; Colistin; Drug Resistance, Multiple, Bacterial; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Infusions, Intravenous; Kidney; Kidney Diseases; Male; Middle Aged; Retrospective Studies; Taiwan; Treatment Outcome |
顯示於: | 醫學系 |
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