Colistin co-administration with other nephrotoxins: experience of teaching hospital of Latvia

Aitullina, Aleksandra; Purvina, S.; Krūmiņa, Angelika

doi:10.1007/s11096-020-01154-6

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…Our study showed no statistically significant difference in nephrotoxicity between groups of patients treated with colistin alone and those treated with colistin in combination with vancomycin ( p = 0.474). Our results are consistent with Aitullina et al [ 11 ] and Garnacho-Montero [ 22 ] found that colistin and vancomycin co-administration are not associated with colistin nephrotoxicity.…”

Section: Discussionsupporting

confidence: 93%

“…Moreover, colistin is commonly used in critically ill patients for the treatment of multidrug-resistant (MDR) Gram-negative bacterial infections [ 3 , 4 ]. Vancomycin has been commonly co-administered with colistin and could increase the risk of colistin nephrotoxicity, but this is still not proven [ 11 ]. However, to date there have been few clinical studies directly evaluating the efficacy and safety of colistin plus vancomycin in combination in critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Efficacy and Nephrotoxicity of Colistin Alone versus Colistin Plus Vancomycin in Critically Ill Patients Infected with Carbapenem-Resistant Acinetobacter baumannii: A Propensity Score-Matched Analysis

Katip

Oberdorfer

2021

Pharmaceutics

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Acinetobacter baumannii has emerged as a significant concern worldwide. The mortality rate of carbapenem-resistant A. baumannii (CRAB) is increasing, especially in the intensive care unit (ICU). Thus, the objective of this study is to compare the efficacy and safety of colistin plus vancomycin for the treatment of critically ill patients with CRAB in Chiang Mai University Hospital. We conducted a retrospective cohort study of critically ill patients in the ICU with CRAB infection who received colistin alone or colistin-vancomycin combination therapy at Chiang Mai University Hospital. A total of 365 critically ill patients met the inclusion criteria. The results in this study showed that after propensity score matching, colistin plus vancomycin showed no significant differences in the 30-day mortality compared to colistin alone. Likewise, for colistin plus vancomycin, compared with colistin therapy alone, there were no significant differences in the clinical response, microbiological response and nephrotoxicity. In conclusion, colistin plus vancomycin was no significant differences in 30-day mortality, clinical response, microbiological response compared to colistin alone for infections due to CRAB. The nephrotoxicity rates were similar for both groups, so colistin combination with vancomycin was not necessary for the management of infection caused by CRAB.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy and Nephrotoxicity of Colistin Alone versus Colistin Plus Vancomycin in Critically Ill Patients Infected with Carbapenem-Resistant Acinetobacter baumannii: A Propensity Score-Matched Analysis

Katip

Oberdorfer

2021

Pharmaceutics

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“…All studies were published from 2003 to 2022. Among the included studies, 9 were RCTs[ 16 , 18 , 23 , 34 , 35 , 54 , 57 , 81 , 87 ], 5 were case–control studies[ 31 , 47 , 51 , 74 , 86 ] and 75 were cohort studies[ 17 , 19 - 22 , 24 - 30 , 32 , 33 , 36 - 46 , 48 - 50 , 52 , 53 , 55 , 56 , 58 - 73 , 75 - 80 , 82 - 85 , 88 - 104 ]. The sample sizes per study ranged from 11 to 4910 critically ill patients.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of polymyxin-induced nephrotoxicity and its predictors in critically ill adult patients: A meta-analysis

Wang¹,

Xiang²,

Song³

et al. 2022

World J Clin Cases

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BACKGROUND Polymyxin-induced nephrotoxicity is a major safety concern in clinical practice due to long-term adverse outcomes and high mortality. AIM To conducted a systematic review and meta-analysis of the prevalence and potential predictors of polymyxin-induced nephrotoxicity in adult intensive care unit (ICU) patients. METHODS PubMed, EMBASE, the Cochrane Library and Reference Citation Analysis database were searched for relevant studies from inception through May 30, 2022. The pooled prevalence of polymyxin-induced nephrotoxicity and pooled risk ratios of associated factors were analysed using a random-effects or fixed-effects model by Stata SE ver. 12.1. Additionally, subgroup analyses and meta-regression were conducted to assess heterogeneity. RESULTS A total of 89 studies involving 12234 critically ill adult patients were included in the meta-analysis. The overall pooled incidence of polymyxin-induced nephrotoxicity was 34.8%. The pooled prevalence of colistin-induced nephrotoxicity was not higher than that of polymyxin B (PMB)-induced nephrotoxicity. The subgroup analyses showed that nephrotoxicity was significantly associated with dosing interval, nephrotoxicity criteria, age, publication year, study quality and sample size, which were confirmed in the univariable meta-regression analysis. Nephrotoxicity was significantly increased when the total daily dose was divided into 2 doses but not 3 or 4 doses. Furthermore, older age, the presence of sepsis or septic shock, hypoalbuminemia, and concomitant vancomycin or vasopressor use were independent risk factors for polymyxin-induced nephrotoxicity, while an elevated baseline glomerular filtration rate was a protective factor against colistin-induced nephrotoxicity. CONCLUSION Our findings indicated that the incidence of polymyxin-induced nephrotoxicity among ICU patients was high. It emphasizes the importance of additional efforts to manage ICU patients receiving polymyxins to decrease the risk of adverse outcomes.

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“…[31][32][33] Additionally, using new antibiotics and combinations of antibiotics in MDR will increase AKI and nephrotoxicity. [34][35][36][37][38] It is worth mentioning that the abuse of antibiotics in healthy individuals can increase the risk of MDR in the community. 39,40 Many other risk factors were identified to increase the incidence of MDR even in people as carriers, such as travel history to areas endemic with MDR, health occupations, comorbidities including DM and inflammatory bowel disease, immunosuppressive drugs and chemotherapy, AIDS, cystic fibrosis and extreme of ages.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Among Patients with Multi-Drug Resistant Infection: A Study from Jordan

Oweis¹,

Zeyad²,

Alshelleh³

et al. 2022

JMDH

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Background: Acute kidney injury (AKI) is a well-known complication for hospitalized patients. Sepsis and various infections play a significant role in increasing the incidence of AKI. The present study evaluated the risk for Multidrug-resistant (MDR) infections and its effect on the incidence of AKI, hospitalization, need for dialysis, and mortality. Methods: In a retrospective study design, data were collected from all adult patients with a positive multi-drug resistant culture who were admitted to King Abdullah University Hospital (KAUH). Records of 436 patients were reviewed between January 2017 -December 2018 with at least one year of follow-up. Results: The mean age was 57.3 years (SD± 23.1), and 58.5% were males. The most common source of positive cultures was sputum, with 50% positive cultures. The incidence of AKI was 59.2%. The most isolated microorganism was Acinetobacter baumannii (76.8%), followed by Pseudomonas aeruginosa (14.9%).On multivariate analysis, age (OR 1.1, 95% CI 1.1-1.2, P=0.001), HTN (OR 1.8, 95% CI 1.0-3.3, P=0.02), DM (OR 1.1, 95% CI 0.6-1.9, P=0.69) and the use of Foley catheter on chronic bases (OR 4.3, 95% CI 2.6-6.8, P<0.0001) were strong predictors of AKI. Among patients with AKI, 74.4% died compared to 44.4% among non-AKI patients (p<0.001). Conclusion:In patients with MDR, AKI incidence, hospitalization, and mortality were high. Early detection and addressing the problem may decrease bad outcomes, and health education for reducing antibiotic abuse is needed to lower MDR.

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Colistin co-administration with other nephrotoxins: experience of teaching hospital of Latvia

Cited by 7 publications

References 26 publications

Clinical Efficacy and Nephrotoxicity of Colistin Alone versus Colistin Plus Vancomycin in Critically Ill Patients Infected with Carbapenem-Resistant Acinetobacter baumannii: A Propensity Score-Matched Analysis

Clinical Efficacy and Nephrotoxicity of Colistin Alone versus Colistin Plus Vancomycin in Critically Ill Patients Infected with Carbapenem-Resistant Acinetobacter baumannii: A Propensity Score-Matched Analysis

Prevalence of polymyxin-induced nephrotoxicity and its predictors in critically ill adult patients: A meta-analysis

Acute Kidney Injury Among Patients with Multi-Drug Resistant Infection: A Study from Jordan

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