Colistin as a salvage therapy for nosocomial infections caused by multidrug-resistant bacteria in the ICU

Kallel, Hatem; Bahloul, Mabrouk; Hergafi, Leila; Akrout, Malek; Ketata, W.; Chelly, Hédi; Hamida, Chokri Ben; Rekik, Noureddine; Hammami, Adnane; Bouaziz, Mounir

doi:10.1016/j.ijantimicag.2006.07.008

Cited by 100 publications

(76 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…baumannii infections, clinical success is not as high as expected in the treatment of VAP. 18,19 Among the anti-MDR-A. baumannii antibiotics, TIG has received significant attention.…”

Section: Discussionmentioning

confidence: 99%

In vitro synergistic activity of tigecycline and colistin against XDR-Acinetobacter baumannii

et al. 2009

View full text Add to dashboard Cite

The emergence of extensive drug-resistant (XDR) Acinetobacter baumannii limits the therapeutic options and leads to high mortality in intensive care units. Combined antibiotic therapy is frequently recommended for the treatment of these infections. Colistin (CO) and tigecycline (TIG), alone or in combination with other antimicrobials, are the most commonly used antibiotics in the treatment of these resistant infections. In this study, the in vitro synergistic activity of TIG and CO were tested for 25 XDR-A. baumannii strains isolated from ventilator-associated pneumonia by the Etest method. Resistance to CO was not detected, whereas 8% of the strains were resistant to TIG. The TIG-CO combination was more synergistic than TIG-rifampin and CO-rifampin according to the fractional inhibitory concentration index. No antagonism was detected between the drugs in the study. There was no strong correlation between the activity of the combinations with reference to strains or genotypes. Our results suggest that the combined use of TIG and CO may be useful for the treatment of XDR-A. baumannii infections.

show abstract

“…baumannii infections, clinical success is not as high as expected in the treatment of VAP. 18,19 Among the anti-MDR-A. baumannii antibiotics, TIG has received significant attention.…”

Section: Discussionmentioning

confidence: 99%

In vitro synergistic activity of tigecycline and colistin against XDR-Acinetobacter baumannii

et al. 2009

View full text Add to dashboard Cite

show abstract

“…[1,4,5,17] Two studies have achieved a positive clinical response of 73.0 -80.8% and a microbiological response of 94.9% when using colistin in the treatment of MDR Gram-negative infections. [18,19] Kallel et al [7] achieved a positive clinical response of 60% with colistin in the treatment of pneumonia associated with resistant A. baumannii and Pseudomonas aeruginosa. The clinical response rate varies between 38 and 57% and the microbiological response rate varies between 45 and 69% in pneumonia treatment with colistin therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Colistin, which is almost the only available treatment option for MDR Gram-negative infections, is often used in combination therapies in order to reduce resistance and improve efficacy. [6,7] The primary objective of the study was to determine whether there was a mortality difference between colistin and colistin combination therapies in MDR-AB nosocomial pneumonia/ ventilator-associated pneumonia (VAP). Secondary objectives were to investigate clinical response, bacterial eradication and nephrotoxicity in colistin monotherapy and colistin combinations in MDR-AB associated pneumonia/VAP.…”

mentioning

confidence: 99%

Comparison of the efficacy of colistin monotherapy and colistin combination therapies in the treatment of nosocomial pneumonia and ventilator-associated pneumonia caused by Acinetobacter baumannii

et al. 2015

View full text Add to dashboard Cite

Objective. To investigate whether there was a difference in mortality, clinical response and bacterial eradication between colistin monotherapy and colistin combination therapies for the treatment of nosocomial pneumonia/ventilator-associated pneumonia (VAP) caused by Acinetobacter baumannii in a medical intensive care unit (ICU). Methods. This retrospective, observational and single-centre study included all patients who were in the medical ICU of Gazi University Medical Faculty Hospital and diagnosed with nosocomial pneumonia/VAP caused by A. baumannii between January 2009 and September 2014. Results. The median age of the 134 patients was 68 years and 53.3% were male. The most common causes of admission were respiratory insufficiency (66.7%) and sepsis/septic shock (54.8%). In patients with nosocomial pneumonia/VAP caused by A. baumannii, on median day 5 of admission, colistin monotherapy was used in 23 (21.6%) patients, a carbapenem combination was used in 80 (59.7%) patients, sulbactam-ampicillin combination was used in 42 (31.4%) patients, tigecycline combination was used in 26 (19.4%) patients, and sulbactam-cefoperazone combination was used in 17 (12.7%) patients. Median ICU stay of the patients was 15.5 days, and 112 (83.6%) patients died. Colistin monotherapy and combination therapies had no superiority over each other in clinical response for the treatment of A. baumannii-associated nosocomial pneumonia/VAP. Mortality was found to be higher in patients receiving the colistin-carbapenem combination (64.3% v. 36.4%, p=0.016). Discharge/day-of-death Sequential Organ Failure Assessment score (odds ratio (OR) 2.017, 95% confidence interval (CI) 1.330 -3.061) and vasopressor use (OR 9.014, 95% CI 1.360 -59.464) were independent risk factors for ICU mortality. Conclusion. Colistin monotherapy and combination therapies have no superiority over each other for clinical response in the treatment of nosocomial pneumonia/VAP caused by multidrug-resistant A. baumannii. Colistin-SAM was associated with improved microbiological eradication and colistin-carbapenem combination was associated with increased mortality.S Afr J Crit Care 2015;31(2):51-58.

show abstract

“…The excellent in vitro activity of colistin has been demonstrated previously by several studies but its systemic use is limited due to the adverse effects. The most common adverse effects of colistin therapy are nephrotoxicity, neuromuscular blockade, and neurotoxicity and the less common effects are hypersensitivity reactions, skin rash, urticaria, generalized itching, fever, and mild gastrointestinal disorders (24)(25)(26)(27). Given the high resistance rate of CRAB to almost all classic antibiotics, colistin remains as the last resort antibiotic for treatment of CRAB associated infections (28).…”

Section: Antibioticsmentioning

confidence: 99%

Carbapenem-resistant Acinetobacter baumannii (CRAB) Recovered from Burn Patients

Adibhesami¹,

Douraghi²,

Zeraati³

et al. 2016

J Pharm Pharm Sci

View full text Add to dashboard Cite

show abstract

Colistin as a salvage therapy for nosocomial infections caused by multidrug-resistant bacteria in the ICU

Cited by 100 publications

References 13 publications

In vitro synergistic activity of tigecycline and colistin against XDR-Acinetobacter baumannii

In vitro synergistic activity of tigecycline and colistin against XDR-Acinetobacter baumannii

Comparison of the efficacy of colistin monotherapy and colistin combination therapies in the treatment of nosocomial pneumonia and ventilator-associated pneumonia caused by Acinetobacter baumannii

Carbapenem-resistant Acinetobacter baumannii (CRAB) Recovered from Burn Patients

Contact Info

Product

Resources

About