Cargando…

Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients

INTRODUCTION: The increasing prevalence of multiresistant Gram-negative strains in intensive care units (ICUs) has recently rekindled interest in colistin, a bactericidal antibiotic that was used in the 1960s for treatment of infections caused by Gram-negative bacilli. We conducted the present obser...

Descripción completa

Detalles Bibliográficos
Autores principales: Markou, Nikolaos, Apostolakos, Haralampos, Koumoudiou, Christiana, Athanasiou, Maria, Koutsoukou, Alexandra, Alamanos, Ioannis, Gregorakos, Leonidas
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC270720/
https://www.ncbi.nlm.nih.gov/pubmed/12974973
http://dx.doi.org/10.1186/cc2358
_version_ 1782121047780229120
author Markou, Nikolaos
Apostolakos, Haralampos
Koumoudiou, Christiana
Athanasiou, Maria
Koutsoukou, Alexandra
Alamanos, Ioannis
Gregorakos, Leonidas
author_facet Markou, Nikolaos
Apostolakos, Haralampos
Koumoudiou, Christiana
Athanasiou, Maria
Koutsoukou, Alexandra
Alamanos, Ioannis
Gregorakos, Leonidas
author_sort Markou, Nikolaos
collection PubMed
description INTRODUCTION: The increasing prevalence of multiresistant Gram-negative strains in intensive care units (ICUs) has recently rekindled interest in colistin, a bactericidal antibiotic that was used in the 1960s for treatment of infections caused by Gram-negative bacilli. We conducted the present observational study to evaluate the efficacy of intravenous colistin in the treatment of critically ill patients with sepsis caused by Gram-negative bacilli resistant to all other antibiotics. PATIENTS AND METHOD: Critically ill patients with sepsis caused by Gram-negative bacilli resistant to all antibiotics with the exception of colistin were treated in the six-bed ICU of a trauma hospital. Diagnosis of infection was based on clinical data and isolation of bacteria, and the bacteria were tested with respect to their susceptibility to colistin. Clinical response to colistin was evaluated. RESULTS: Twenty-four patients (mean age 44.3 years, mean Acute Physiology and Chronic Health Evaluation II score 20.6) received 26 courses of colistin. Clinical response was observed for 73% of the treatments. Survival at 30 days was 57.7%. Deterioration in renal function was observed in 14.3% of 21 patients who were not already receiving renal replacement therapy, but in only one case did this deterioration have serious clinical consequences. CONCLUSION: The lack of a control group in the present study does not allow any definite conclusions to be drawn regarding the clinical effectiveness of colistin. On the other hand, this drug has an acceptable safety profile and its use should be considered in severe infections with multiresistant Gram-negative bacilli.
format Text
id pubmed-270720
institution National Center for Biotechnology Information
language English
publishDate 2003
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-2707202003-11-21 Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients Markou, Nikolaos Apostolakos, Haralampos Koumoudiou, Christiana Athanasiou, Maria Koutsoukou, Alexandra Alamanos, Ioannis Gregorakos, Leonidas Crit Care Research INTRODUCTION: The increasing prevalence of multiresistant Gram-negative strains in intensive care units (ICUs) has recently rekindled interest in colistin, a bactericidal antibiotic that was used in the 1960s for treatment of infections caused by Gram-negative bacilli. We conducted the present observational study to evaluate the efficacy of intravenous colistin in the treatment of critically ill patients with sepsis caused by Gram-negative bacilli resistant to all other antibiotics. PATIENTS AND METHOD: Critically ill patients with sepsis caused by Gram-negative bacilli resistant to all antibiotics with the exception of colistin were treated in the six-bed ICU of a trauma hospital. Diagnosis of infection was based on clinical data and isolation of bacteria, and the bacteria were tested with respect to their susceptibility to colistin. Clinical response to colistin was evaluated. RESULTS: Twenty-four patients (mean age 44.3 years, mean Acute Physiology and Chronic Health Evaluation II score 20.6) received 26 courses of colistin. Clinical response was observed for 73% of the treatments. Survival at 30 days was 57.7%. Deterioration in renal function was observed in 14.3% of 21 patients who were not already receiving renal replacement therapy, but in only one case did this deterioration have serious clinical consequences. CONCLUSION: The lack of a control group in the present study does not allow any definite conclusions to be drawn regarding the clinical effectiveness of colistin. On the other hand, this drug has an acceptable safety profile and its use should be considered in severe infections with multiresistant Gram-negative bacilli. BioMed Central 2003 2003-07-28 /pmc/articles/PMC270720/ /pubmed/12974973 http://dx.doi.org/10.1186/cc2358 Text en Copyright © 2003 Markou et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Research
Markou, Nikolaos
Apostolakos, Haralampos
Koumoudiou, Christiana
Athanasiou, Maria
Koutsoukou, Alexandra
Alamanos, Ioannis
Gregorakos, Leonidas
Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients
title Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients
title_full Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients
title_fullStr Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients
title_full_unstemmed Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients
title_short Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients
title_sort intravenous colistin in the treatment of sepsis from multiresistant gram-negative bacilli in critically ill patients
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC270720/
https://www.ncbi.nlm.nih.gov/pubmed/12974973
http://dx.doi.org/10.1186/cc2358
work_keys_str_mv AT markounikolaos intravenouscolistininthetreatmentofsepsisfrommultiresistantgramnegativebacilliincriticallyillpatients
AT apostolakosharalampos intravenouscolistininthetreatmentofsepsisfrommultiresistantgramnegativebacilliincriticallyillpatients
AT koumoudiouchristiana intravenouscolistininthetreatmentofsepsisfrommultiresistantgramnegativebacilliincriticallyillpatients
AT athanasioumaria intravenouscolistininthetreatmentofsepsisfrommultiresistantgramnegativebacilliincriticallyillpatients
AT koutsoukoualexandra intravenouscolistininthetreatmentofsepsisfrommultiresistantgramnegativebacilliincriticallyillpatients
AT alamanosioannis intravenouscolistininthetreatmentofsepsisfrommultiresistantgramnegativebacilliincriticallyillpatients
AT gregorakosleonidas intravenouscolistininthetreatmentofsepsisfrommultiresistantgramnegativebacilliincriticallyillpatients