Evaluation of Risk Factors for Intravenous Colistin Use-related Nephrotoxicity

Köksal, İftihar; Kaya, Selçuk; Gençalioğlu, Eda; Yılmaz, Gürdal

doi:10.5001/omj.2016.62

Cited by 19 publications

(18 citation statements)

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“…A. baumanni was observed to be the causative microorganism in all patients, and the most frequent infection was pneumonia. Similar to our study, it was determined that A. baumannii is the most common agent in other studies [ 8 , 18 , 22 ], and the most frequent infection is pneumonia [ 8 , 12 , 18 , 19 ].…”

Section: Discussionsupporting

confidence: 89%

“…Nephrotoxicity ratios differ in studies conducted on the subject, and it is thought that this difference may be due to different patient populations and the use of different criteria. In recent years, for obtaining more standardized data, varying criteria have been used, and the RIFLE criteria provide a useful framework for nephrotoxicity [ 8 , 14 ]. Ricci et al [ 15 ] defined the RIFLE classification as a simple, readily available clinical tool to classify AKI in different populations.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, its administration has been reinitiated in the treatment of multi-drug resistant pathogens (MDRP) such as Acinetobacter baumannii, Pseudomonas aeruginosa, and carbapenem-resistant Enterobacteriaceae. Nephrotoxicity and neurotoxicity are the main problems encountered in the clinical use of polymyxins [ 5 - 8 ]. In this study, our aim was to determine the frequency and risk factors of colistin-related nephrotoxicity in the adult ICU.…”

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confidence: 99%

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Determination of Colistin-Related Nephrotoxicity and Risk Factors in Intensive Care Unit

İnci

Toker

Bicer

et al. 2017

North Clin Istanbul

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OBJECTIVE:Colistin is a cationic polypeptide antibiotic with a cyclic structure that belongs to the polymyxin group. It was banned from clinical use because of its significant renal side effects, such as nephrotoxicity. However, the administration of colistin has recently been initiated again in the treatment of multi-drug resistant pathogens, such as Acinetobacter baumannii and Pseudomonas aeruginosa. Nephrotoxicity and neurotoxicity are the main problems encountered in the clinical use of polymyxins. The aim of this study was to determine the frequency and risk factors of colistin-related nephrotoxicity in the adult intensive care unit (ICU).METHODS:In this study, a retrospective review of patients who were followed up between January 1 and December 31, 2016 and who received colistin treatment in the adult ICU was performed. Retrospective computer records of age, sex, site of infection and microorganism breeding, daily creatinine values, and additional diseases were recorded and examined. Nephrotoxicity was assessed using the Risk, Injury, Failure, Loss, and End-stage kidney disease criteria.RESULTS:A total of 48 patients were included in the study. Of these, 50% were male. The mean age of the patients with nephrotoxicity was 59.73±22.38 years, and the mean age of those without nephrotoxicity was 58.00±22.39 years. A. baumanni was observed to be the causative microorganism in all patients, and the most frequent infection was pneumonia. Nephrotoxicity was investigated in 54.2% (n=26) of the patients. In this study, when risk factors for nephrotoxicity were evaluated, it was found that the presence of nephrotoxicity was greater in cases with chronic obstructive pulmonary disease, malignancy, or abdominal surgery in patients older than 65 years. In addition, mortality was greater in those who developed nephrotoxicity, although it was not statistically significant.CONCLUSION:In this study, the rate of nephrotoxicity was 54.2% in patients who received colistin in the ICU. Therefore, patients in the adult ICU receiving colistin therapy should be carefully monitored for the development of nephrotoxicity as a side effect.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Determination of Colistin-Related Nephrotoxicity and Risk Factors in Intensive Care Unit

İnci

Toker

Bicer

et al. 2017

North Clin Istanbul

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“…These findings were also similar to the results from previous reports. According to Koksal I, age was positively correlated with nephrotoxicity 10 . The majority of patients in this study population aged 60 or over and nephrotoxicity was observed in 41.8% of patients in this group while only 19.2% of patients under-60 experienced the event.…”

Section: Discussionmentioning

confidence: 99%

Investigation on colistin use at the University Medical Center Hochiminh City

Truong¹,

Nguyen²

2018

Pharm Sci Asia

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Antibiotic resistance has turned into a global crisis, with pathogens being less susceptible or even resistant to last-resort antibiotics. In 2010, Lim LM estimated that no new antibiotics with activity against multidrug-resistant (MDR) gram-negative bacteria such as Pseudomonas aeruginosa, Acinetobacter baumanii and Klebsiella pneumoniae are expected to be released within the next five years 1. This high lights the role of colistin, an old-class antibiotic that still remains the last-line therapy in clinical settings. The spread of colistin use has recently raised concerns about resistance to this antibiotic.

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“…and risk factors for renal damage caused by Colistin. Factors associated with renal damage were old age, high levels of Creatinine, diabetes, and chronic obstructive pulmonary disease (41). Binh and colleagues (2015) reported a 67.9% success rate when treating patients with Colistin.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Renal Damage in Patients with Multi-Drug Resistant Strains of Pneumonia Treated with Colistin

Moghadam¹,

Ghanbarpour²,

Niakan³

et al. 2018

Trauma Mon

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Background: Treatment of multi-drug-resistant strains of pneumonia with common antibiotics in renal patients is aborted and physicians are compelled to use Colistin for such cases. Objectives: This study was conducted to assess the mortality, length of stay, and renal damages in the treatment of multi-drugresistant pneumonia with Colistin among multiple trauma patients admitted to the emergency department and transferred to the ICU. Methods: This retrospective cohort study was conducted between 2011 and 2016. 102 multiple trauma (MT) patients with multidrug-resistant strains of hospital-acquired pneumonia (HAP) admitted to the emergency department then transferred to the ICU were assessed. All patients received Colistin according to their weight. Renal damage was evaluated according to the RIFLE criteria. The mortality and the length of stay were assessed. In order to statistically analyze the data, SPSS version 23 software was used to conduct t-test and chi-square test. Results: Out of 102 patients, 55 (54%) died and 50 (49.1%) developed acute renal failure; 64 cases had no hypertension. Patients according to the RIFLE index were assessed: Risk (11.01%), Injury (14%), Failure (18%), Loss (6%), and End-stage renal disease. The prevalence and prognosis of acute kidney injury in multiple trauma patients treated with Colistin were significantly correlated with drug dosage, body mass index, and use of corticosteroids (when assessed using relevant scoring systems, P < 0.05). Conclusions:The use of a scoring system in the intensive care unit, determining those patients requiring Colistin, and adjusting the dosage of this drug for treatment of MT patients with multi-drug resistant strains of HAP are vital. Creatinine levels must be carefully monitored.

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Evaluation of Risk Factors for Intravenous Colistin Use-related Nephrotoxicity

Abstract: The use of colistin is relatively safe for patients that have normal renal functions. However, better standardization of the definition of nephrotoxicity in those patients with the use of scoring systems and close monitoring are necessary.

Cited by 19 publications

References 19 publications

Determination of Colistin-Related Nephrotoxicity and Risk Factors in Intensive Care Unit

Determination of Colistin-Related Nephrotoxicity and Risk Factors in Intensive Care Unit

Investigation on colistin use at the University Medical Center Hochiminh City

Assessment of Renal Damage in Patients with Multi-Drug Resistant Strains of Pneumonia Treated with Colistin

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