Colistin is relatively safe in hematological malignancies and hematopoietic stem cell transplantation patients

Averbuch, Dina; Horwitz, Ehud; Strahilevitz, Jacob; Stepensky, Polina; Goldschmidt, Neta; Gatt, Moshe E.; Shapira, Michael Y.; Resnick, Igor B.; Engelhard, Dan

doi:10.1007/s15010-013-0471-6

Cited by 15 publications

(14 citation statements)

References 38 publications

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“…For MDR P. aeruginosa, colistin seems well tolerated and effective, although the optimal dose remains to be established and there is great confusion in terms of two formulations [62,63]. This problem has been discussed extensively by Nation et al [64 & ].…”

Section: Multidrug Resistant Gram-negative Bacteriamentioning

confidence: 99%

Bacterial infections in hematopoietic stem cell transplantation recipients

Mikulska

Bono

Viscoli

2014

Current Opinion in Hematology

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Section: Multidrug Resistant Gram-negative Bacteriamentioning

confidence: 99%

Bacterial infections in hematopoietic stem cell transplantation recipients

Mikulska

Bono

Viscoli

2014

Current Opinion in Hematology

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“…The patient was also on 2 concomitant nephrotoxins (first "0" in the Pogue model and "1" in the Collins model) but received no rifampin (last "0" in the Pogue model). Risk factors evaluated based on a time-to-event analysis 16 Did not report risk factors…”

Section: Appendixmentioning

confidence: 99%

Validation of a Model To Predict the Risk of Nephrotoxicity in Patients Receiving Colistin

Phe

Johnson

Palmer

et al. 2014

Antimicrob Agents Chemother

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b Despite concerns about its nephrotoxicity, colistin often remains the only effective agent for treating multidrug-resistant Gramnegative infections. Published studies have reported a wide range of nephrotoxicity risk factors. To assess the clinical utility of various models, we compared their performances for predicting the risk of nephrotoxicity. We identified a model demonstrating reasonable overall risk assessment, with an observed/expected ratio of 1.29 (95% confidence interval [CI], 0.68 to 1.90) and a positive predictive value of 87.5% for identifying patients at high risk of developing nephrotoxicity. Multidrug-resistant (MDR) infections caused by Gram-negative bacteria are increasing worldwide and are associated with significant morbidity and mortality (1, 2). With a lack of new antibiotics in development, there has been a resurgence in the use of colistin, as it still demonstrates activity against many of these MDR organisms. However, colistin is associated with significant nephrotoxicity, which limits its widespread use.Numerous studies have evaluated the prevalence of colistinassociated nephrotoxicity, but the rates vary widely in the literature, ranging anywhere from 10% to 48% (3-6). The reasons for such wide variability are multifactorial. One possible explanation is the different definitions used for nephrotoxicity. Earlier studies did not utilize a standardized definition and generally reported lower rates of nephrotoxicity (4, 7). In more recent years, studies have used the risk, injury, failure, loss, and end-stage renal disease (RIFLE) criteria as a standardized definition for acute kidney injury (8). The rates of colistin-associated nephrotoxicity in these studies are more consistent, with a range between 31% and 48% (5, 6, 9-12). However, the reported risk factors associated with nephrotoxicity vary considerably in these studies. Thus, it is unclear which risk factors are most predictive of colistin-associated nephrotoxicity.With the high rate of nephrotoxicity associated with colistin use, identifying patients at high risk for developing nephrotoxicity is important for optimizing colistin therapy (i.e., weighing the risk versus benefits of initiating or continuing therapy). A direct comparison of the different mathematical models used to identify patients at high risk for colistin-associated nephrotoxicity has not been undertaken. To assess the clinical utility of various mathematical prediction models, the objectives of this study were to compare their performances in (i) predicting the overall risk of nephrotoxicity in a population of patients receiving colistin and (ii) identifying patients at high risk for developing colistin-associated nephrotoxicity.A literature search was conducted using PubMed to identify prediction models from published studies that evaluated independent risk factors for colistin-associated nephrotoxicity. Studies were included if they were published in English in the last 10 years and they defined nephrotoxicity according to the RIFLE criteria. The full logistic...

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“…Despite renal toxicity (0-50%), it has been found to be safe in neutropenic patients. [104][105][106] and is recommended for treatment of carbapenemresistant Enterobacteriaceae and P. aeruginosa [102]. Successful treatment of MDR Pseudomonas has been demonstrated in bacteraemic haematology patients, predominately in conjunction with a beta-lactam agent.…”

Section: Resistant Gram-negative Infectionsmentioning

confidence: 99%

The prevention and management of infections due to multidrug resistant organisms in haematology patients

Trubiano

Worth

Thursky

et al. 2015

Brit J Clinical Pharma

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Infections due to resistant and multidrug resistant (MDR) organisms in haematology patients and haematopoietic stem cell transplant recipients are an increasingly complex problem of global concern. We outline the burden of illness and epidemiology of resistant organisms such as gram-negative pathogens, vancomycin-resistant Enterococcus faecium (VRE), and Clostridium difficile in haematology cohorts. Intervention strategies aimed at reducing the impact of these organisms are reviewed: infection prevention programmes, screening and fluoroquinolone prophylaxis. The role of newer therapies (e.g. linezolid, daptomycin and tigecycline) for treatment of resistant and MDR organisms in haematology populations is evaluated, in addition to the mobilization of older agents (e.g. colistin, pristinamycin and fosfomycin) and the potential benefit of combination regimens.

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Colistin is relatively safe in hematological malignancies and hematopoietic stem cell transplantation patients

Cited by 15 publications

References 38 publications

Bacterial infections in hematopoietic stem cell transplantation recipients

Bacterial infections in hematopoietic stem cell transplantation recipients

Validation of a Model To Predict the Risk of Nephrotoxicity in Patients Receiving Colistin

The prevention and management of infections due to multidrug resistant organisms in haematology patients

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