Intravenous colistin as therapy for nosocomial infections caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii

Clin Infect Dis. 1999 May;28(5):1008-11. doi: 10.1086/514732.

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.

Publication types

  • Clinical Trial

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Colistin / adverse effects
  • Colistin / therapeutic use*
  • Creatinine / blood
  • Cross Infection / drug therapy*
  • Drug Resistance, Multiple
  • Female
  • Humans
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Pseudomonas Infections / drug therapy*

Substances

  • Anti-Bacterial Agents
  • Creatinine
  • Colistin