2013
DOI: 10.1007/s15010-013-0507-y
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Colistin bladder instillation, an alternative way of treating multi-resistant Acinetobacter urinary tract infection: a case series and review of literature

Abstract: The multiresistant Acinetobacter species bacteria are frequently involved in urinary or respiratory tract infections, and one of the most effective drugs, colistine, is associated with significant nephrotoxicity and neurotoxicity. Given that very high concentrations of colistine into biological fluids are safe for the human organism, attempts have been made at delivering the drug topically, by aerosol, or, occasionally, intratechally or intraventricularly for meningitis. These topical treatments could eradicat… Show more

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Cited by 25 publications
(15 citation statements)
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“…Although majority of studies (7/11) used gentamicin as the IVA, this included 3 where it was used as treatment and 4 where it was used a prophylaxis against rUTI [ 2 , 4 , 5 , 8 ••, 9 , 10 •, 11 ]. The other IVA used were a combination of neomycin/polymyxin ( n = 2) and isolated neomycin and colistin in one study each [ 1 , 3 •, 6 , 7 ]. The majority of participants had neurogenic bladders, indwelling catheters or performed intermittent self-catheterisation (ISC), although studies also had patients with urinary diversion (Table 2 ).…”
Section: Resultsmentioning
confidence: 99%
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“…Although majority of studies (7/11) used gentamicin as the IVA, this included 3 where it was used as treatment and 4 where it was used a prophylaxis against rUTI [ 2 , 4 , 5 , 8 ••, 9 , 10 •, 11 ]. The other IVA used were a combination of neomycin/polymyxin ( n = 2) and isolated neomycin and colistin in one study each [ 1 , 3 •, 6 , 7 ]. The majority of participants had neurogenic bladders, indwelling catheters or performed intermittent self-catheterisation (ISC), although studies also had patients with urinary diversion (Table 2 ).…”
Section: Resultsmentioning
confidence: 99%
“…The majority of the participants who underwent the antimicrobial instillation showed a good response with a reduction of symptomatic UTI in 78.2% ( n = 223) (Table 2 ). A high success rate of 88% ( n = 103%) was seen in the treatment group in the short term (3–6 months) [ 1 , 2 , 3 •, 4 , 5 ], with a low discontinuation rate of 5% ( n = 6). A success rate of 71% ( n = 120) was seen in the prophylaxis group in the short term [ 6 , 7 , 8 ••, 9 , 10 •, 11 ], with a discontinuation rate of 8% ( n = 14).…”
Section: Resultsmentioning
confidence: 99%
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“…In addition to topical agents, other examples of local therapy are the use of inhaled antimicrobials and bladder irrigations. [111][112][113][114][115] Consideration should be given to chemical structure, disease state alterations in V d , and target site to aid selection and dosing of antimicrobials.…”
Section: Dosing Pharmacokineticsmentioning
confidence: 99%
“…This toxicity together with the need to tackle MDR-GNB has led to topical routes of administration, such as intrathecal and intraventricular, as well as by inhalation. Instillation in the bladder for urinary tract infections (UTI) caused by Acinetobacter baumani has been reported to be effective [5,6] . However, there are few reports in the literature of its use against UTI due to P. aeruginosa [7] .…”
Section: Introductionmentioning
confidence: 99%