Intravenous Colistin as Therapy for Nosocomial Infections Caused by Multidrug‐Resistant Pseudomonas aeruginosa and Acinetobacter baumannii

Abstract

Sixty nosocomial infections caused by Pseudomonas aeruginosa and Acinetobacter baumannii resistant to aminoglycosides, cephalosporins, quinolones, penicillins, monobactams, and imipenem were treated with colistin (one patient had two infections that are included as two different cases). The infections were pneumonia (33% of patients), urinary tract infection (20%), primary bloodstream infection (15%), central nervous system infection (8%), peritonitis (7%), catheter-related infection (7%), and otitis media (2%). A good outcome occurred for 35 patients (58%), and three patients died within the first 48 hours of treatment. The poorest results were observed in cases of pneumonia: only five (25%) of 20 had a good outcome. A good outcome occurred for four of five patients with central nervous system infections, although no intrathecal treatment was given. The main adverse effect of treatment was renal failure; 27% of patients with initially normal renal function had renal failure, and renal function worsened in 58% of patients with abnormal baseline creatinine levels. Colistin may be a good therapeutic option for the treatment of severe infections caused by multidrug-resistant P. aeruginosa and A. baumannii.

Early infections in adult patients undergoing unrelated donor cord blood transplantation

“…31 Adding colistin to the prophylaxis regimen in high-risk patients and limiting the patient's admission into intensive care units as far as possible may be a reasonable strategy with which to minimize Acinetobacter spp infections in UD-CBT. 32 In the present series, the CMV reactivation rate was similar to, or even lower than that observed after related-donor and UD-BMT. 17,18,33 This finding is probably due to ganciclovir prophylaxis, with a three to five times per week regimen, in those patients at risk (CMV-seropositive).…”

What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecycline

“…Colistin is increasingly used but has nephrotoxicity and uncertain efficacy in pulmonary infections, although it appears more consistently effective in other infection types [10,11]. Moreover, in some cases, colistin resistance is selected during therapy, and this may apply for the resistant E. cloacae with NDM-1 enzyme in the present study, which was from a child who had already received colistin for Acinetobacter and Pseudomonas infections [12].…”

Colistin therapy for microbiologically documented multidrug-resistant Gram-negative bacterial infections: a retrospective cohort study of 258 patients

“…polymyxins (colistin and polymyxin B), an antibiotic class discovered more that 60 years ago that had been abandoned for nearly 20 years, except for in the distinct population of patients with cystic fibrosis [2]. A number of recently published clinical studies have suggested that colistin may be considered in the treatment of patients with MDR Gram-negative bacterial infections [3][4][5][6][7][8][9].…”