Efficacy and safety of polymyxin E sulfate in the treatment of critically ill patients with carbapenem-resistant organism infections

Lü, Xin; Zhong, Chengliang; Liu, Yanbin; Ye, Hui; Qu, Junyan; Zong, Zhiyong; Lv, Xiaoju

doi:10.3389/fmed.2022.1067548

Cited by 4 publications

(2 citation statements)

References 48 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, the clinical data of 118 patients with CRO infections treated with colistin sulfate were retrospectively analyzed. Based on the product sheet’s recommended dose of 1.0–1.5 million IU per day, clinical response and bacterial clearance was achieved in 74.6% and 65.3%, respectively, showing superior effectiveness over that previously published retrospective studies by Jin et al (58% and 40%, respectively) and Lu et al (53.8% and 49.1%, respectively) [ 29 ]. Notably, in the current study population, approximately six in ten patients had pulmonary infections, while none of these patients received nebulized antibiotic therapy.…”

Section: Discussionmentioning

confidence: 84%

Clinical Efficacy and Safety of Colistin Sulfate in the Treatment of Carbapenem-Resistant Organism Infections in Patients with Hematological Diseases

Wu,

Jiang,

et al. 2024

Infect Dis Ther

View full text Add to dashboard Cite

Introduction Carbapenem-resistant organisms (CRO) have emerged as a significant worldwide issue. However, the availability of efficacious antibiotics for treating CRO infections remains limited. Polymyxins, including colistin sulfate, represent the last-line therapeutic option against CRO infections. This study aims to retrospectively evaluate the clinical effectiveness and safety of colistin sulfate in managing CRO infections among patients with hematological diseases. Methods Between April 2022 and January 2023, a total of 118 hematological patients diagnosed with CRO infection were treated with colistin sulfate at Suzhou Hongci Hospital of Hematology. The assessment encompassed the clinical efficacy, bacterial clearance rate, adverse reactions, and 30-day all-cause mortality. Results The study found that the total effective rate of colistin sulfate in the treatment of CRO infection was 74.6%, with a bacterial clearance rate of 72.6%. Throughout the treatment, nephrotoxicity occurred in 7.6% of cases, neurotoxicity in 2.5% of cases, and the 30-day all-cause mortality rate was 22.9%. Multivariate logistic analysis revealed that the treatment course and combination medication with other antimicrobials were independent factors affecting the clinical efficacy of colistin sulfate. Conclusion Our study demonstrates that the treatment of colistin sulfate can achieve high clinical efficacy and microbial responses, with a low risk of nephrotoxicity. This study provides evidence of the positive clinical efficacy and safety of colistin sulfate treatment in these patients. High-quality randomized controlled trials are still needed to further confirm the beneficial role of colistin sulfate.

show abstract

Section: Discussionmentioning

confidence: 84%

Clinical Efficacy and Safety of Colistin Sulfate in the Treatment of Carbapenem-Resistant Organism Infections in Patients with Hematological Diseases

Wu,

Jiang,

et al. 2024

Infect Dis Ther

View full text Add to dashboard Cite

show abstract

“…Nearly 60% to 70% of CMS is eliminated by the kidneys which are an unactivated pre-drug that must be converted into active polymyxin in vivo to have bactericidal effects. The latter two medications can operate directly and do not need to be converted; they are primarily excreted through non-renal pathways [ 9 ]. On CMS and PBS, various clinical trials have been carried out but which drug should be used more frequently to treat infections brought on by CR-GNB in order to ensure higher efficacy and lower incidence of side effects has not yet been determined.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of polymyxin B and colistin sulfate in the treatment of severe comorbid patients infected with CR-GNB

et al. 2023

View full text Add to dashboard Cite

Background With the difficulties in choosing colistin sulfate and polymyxin B sulfate (PBS) for carbapenem-resistant gram-negative bacteria (CR-GNB), we compared the efficacy and safety of these two old polymyxins in treatment of critically ill patients infected with CR-GNB infection. Methods One hundred four patients infected with CR-GNB in ICU were retrospectively grouped by PBS (68 patients) or colistin sulfate (36 patients). Clinical efficacy including symptoms, inflammatory parameters, defervescence, prognosis and microbial efficacy were analyzed. Hepatotoxicity, nephrotoxicity, and hematotoxicity were evaluated by TBiL, ALT, AST, creatinine, and thrombocytes. Results Demographic characteristics between colistin sulfate and PBS were not significantly different. Most of the CR-GNB were cultured in respiratory tract (91.7% vs 86.8%), and almost all were polymyxin-sensitive (98.2% vs 100%, MIC ≤ 2 μg/ml). The microbial efficacy in colistin sulfate (57.1%) was significantly higher than PBS (30.8%) (p = 0.022), however, no significant difference in clinical success was seen in both groups (33.8% vs 41.7%), as well as mortality, defervescence, imaging remission, days in the hospital, microbial reinfections, and prognosis, and almost all patients defervesce within 7 days (95.6% vs 89.5%). Conclusions Both polymyxins can be administrated in critically ill patients infected with CR-GNB and colistin sulfate is superior to PBS in microbial clearance. These results highlight the necessity of identifying CR-GNB patients who may benefit from polymyxin and who are at higher risk of mortality.

show abstract

Nephrotoxicity caused by colistin use in ICU: a single centre experience

Kilic,

Ayar,

Ceylan

et al. 2023

BMC Nephrol

View full text Add to dashboard Cite

Background We aimed to determine the risk factors that may be associated with colistin-induced acute kidney injury (AKI) to promote the safer use of colistin in the treatment of nosocomial infections caused by multidrug-resistant Gram-negative bacteria in intensive care units. Materials and methods This retrospective observational study was conducted among adult patients who received a minimum of 48 h of intravenous colistin from January 2020 to December 2020 at the intensive care unit of a tertiary care hospital. AKI diagnosis and staging were made based on the Kidney Disease Improving Global Outcome Criteria. Results Of 148 patients who received intravenous colistin at a daily dose of 9 million IU, 54 (36%) developed AKI. In the univariate analysis, age, Charlson comorbidity index, APACHE II score, duration of colistin treatment, basal creatinine level, use of vasopressors, and vancomycin were significantly associated with AKI (p < 0.05). The multivariate analysis revealed that the independent predictor of AKI was the use of vasopressors (OR: 3.14; 95% confidence interval: 1.39–97.07; p = 0.06). Conclusion The use of vasopressors in critically ill patients was independently associated with AKI developing during colistin treatment.

show abstract

Efficacy and safety of polymyxin E sulfate in the treatment of critically ill patients with carbapenem-resistant organism infections

Cited by 4 publications

References 48 publications

Clinical Efficacy and Safety of Colistin Sulfate in the Treatment of Carbapenem-Resistant Organism Infections in Patients with Hematological Diseases

Clinical Efficacy and Safety of Colistin Sulfate in the Treatment of Carbapenem-Resistant Organism Infections in Patients with Hematological Diseases

Comparative study of polymyxin B and colistin sulfate in the treatment of severe comorbid patients infected with CR-GNB

Nephrotoxicity caused by colistin use in ICU: a single centre experience

Contact Info

Product

Resources

About