The efficacy and nephrotoxicity associated with colistin use in an intensive care unit in Vietnam: Use of colistin in a population of lower body weight

Binh, Nguyen Gia; Hayakawa, Kayoko; Co, Dao Xuan; Tuan, Nguyen Dang; Anh, Nguyễn Hoàng; Thuy, Nguyen Thi Hong; Phuong, Doan Mai; Hương, Nguyễn Thị Liên; Thuy, Pham Thi Phuong; Chau, Ngo Quy; Nhung, Pham Hong; Gam, Do Thi Hong; Hai, Duong Thanh; Hương, Trần Thu; Anh, Le Van; Takeshita, Nozomi; Ohmagari, Norio

doi:10.1016/j.ijid.2015.03.020

Cited by 15 publications

(11 citation statements)

References 17 publications

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“…Colistin-induced AKI appears to be due to the d-aminobutyric and fatty acid components of the drug, which increase cell membrane permeability resulting in cell lysis and acute tubular necrosis [6]. In the modern era, rates of AKI following colistin therapy range from 21–76% [3–5, 7–11]. Rates vary by predisposing conditions and severity of illness, but also criteria used to define AKI [6, 12].…”

Section: Introductionmentioning

confidence: 99%

Defining the incidence and risk factors of colistin-induced acute kidney injury by KDIGO criteria

et al. 2017

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BackgroundAcute kidney injury (AKI) remains a treatment-limiting toxicity of colistin. Recently developed clinical practice guidelines from the Kidney Disease: Improving Global Outcomes (KDIGO) group have harmonized definitions of AKI, but have not been widely applied to patients receiving colistin.MethodsWe retrospectively defined AKI by KDIGO definitions among adult patients receiving intravenous colistin for ≥ 3 days. Risk factors for AKI within 48 hours and 7 days of initiating colistin were determined by multivariable logistic regression.ResultsAmong 249 patients treated with colistin, rates of AKI were 12% and 29% at 48 hours and 7 days, respectively. At 48 hours, patients in the intensive care unit were at increased risk for AKI. Within 7 days, colistin daily doses >5mg/kg, chronic liver disease, and concomitant vancomycin were independent predictors. Seven percent of patients required renal replacement therapy at a median of 5 days (range: 3–7) following colistin initiation.ConclusionSafe use of colistin is promoted by early detection of AKI with KDIGO criteria, avoiding nephrotoxins, and limiting duration of therapy.

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Section: Introductionmentioning

confidence: 99%

Defining the incidence and risk factors of colistin-induced acute kidney injury by KDIGO criteria

et al. 2017

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“…intravenous polymyxins alone in MDR GNB infections, most of which were pneumonias. It's indicated that the mortality ranged from 0% to 74.3% (4,21,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37), clinical response (cure and improvement) rate 7-82.1%, and microbiological eradication 27.3-73.9% (24,(33)(34)(35)(36)(37)(38). In respect to the colistin only susceptible strains, it's reported that the mortality in hospitals of intravenous colistin monotherapy was 50% (16/32) (Figure 2), 11 patients died in Intensive Care Unit (ICU) (39), and clinical cure was obtained in 82.1% of infectious episodes (23/28) and bacteriological clearance was achieved in 73.9% (17/23) of the cured infectious episodes (38).…”

Section: Combination Therapymentioning

confidence: 99%

“…All 13 patients presented acute kidney injury, with a median of 5 days, but renal function for all cases had improvement when IV colistin was switched to inhaled colistin. Binh NG et al reported that among critically ill Vietnamese patients with low body weight, a loading dose adjusted according to total actual body weight, was associated with low nephrotoxicity (26).…”

Section: Loading Dosesmentioning

confidence: 99%

“…A prospective observation study found that in severe infections due to COS gramnegative bacteria, the high-dose (4.5 MU every 12 hours), extended-interval CMS regimen has a high efficacy, without significant renal toxicity (38). It was indicated that a personalized dosing protocol of colistin was effective, with low nephrotoxicity, among critically ill Vietnamese patients with low body weight (26).…”

Section: Dosing Strategiesmentioning

confidence: 99%

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Intravenous polymyxins: Revival with puzzle

Fei

et al. 2017

BST

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“…Binh and colleagues (2015) reported a 67.9% success rate when treating patients with Colistin. However, 21.4% of the patients experienced renal damage (42). Elefritz and colleagues showed that increasing the dosage of Colistin did not increase the treatment success rate.…”

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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The efficacy and nephrotoxicity associated with colistin use in an intensive care unit in Vietnam: Use of colistin in a population of lower body weight

Abstract: A personalized dosing protocol of colistin was effective, with low nephrotoxicity, among critically ill Vietnamese patients with low body weight. Further studies are warranted for assessing the efficacy and toxicity in a larger cohort.

Cited by 15 publications

References 17 publications

Defining the incidence and risk factors of colistin-induced acute kidney injury by KDIGO criteria

Defining the incidence and risk factors of colistin-induced acute kidney injury by KDIGO criteria

Intravenous polymyxins: Revival with puzzle

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

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