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Colistin Loading Dose in Septic Patients with Gram Negative Infections
PURPOSE: Intravenous (IV) colistin is commonly used to treat multidrug-resistant gram-negative infections. It is primarily eliminated renally and may induce acute kidney injury (AKI) at a rate of up to 53%. Consequently, septic patients who require colistin administration have an additional risk of...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048962/ https://www.ncbi.nlm.nih.gov/pubmed/35498632 http://dx.doi.org/10.2147/IDR.S361244 |
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author | Alshaya, Abdulrahman I Bin Saleh, Khalid Aldhaeefi, Mohammed Baderldin, Hisham A Alamody, Farris O Alhamdan, Qusai A Almusallam, Mohammed A Alshaya, Omar Al Sulaiman, Khalid Alshareef, Shaima Alowais, Shuroug A Al Harbi, Shmeylan A Alghamdi, Ghassan |
author_facet | Alshaya, Abdulrahman I Bin Saleh, Khalid Aldhaeefi, Mohammed Baderldin, Hisham A Alamody, Farris O Alhamdan, Qusai A Almusallam, Mohammed A Alshaya, Omar Al Sulaiman, Khalid Alshareef, Shaima Alowais, Shuroug A Al Harbi, Shmeylan A Alghamdi, Ghassan |
author_sort | Alshaya, Abdulrahman I |
collection | PubMed |
description | PURPOSE: Intravenous (IV) colistin is commonly used to treat multidrug-resistant gram-negative infections. It is primarily eliminated renally and may induce acute kidney injury (AKI) at a rate of up to 53%. Consequently, septic patients who require colistin administration have an additional risk of developing AKI. The aim of this study is to investigate clinical failure and AKI predictors for septic patients treated with IV colistin. METHODS: This retrospective cohort study was conducted at a tertiary teaching hospital in Saudi Arabia. Adult septic patients with suspected or confirmed gram-negative infections who received colistin admitted to the hospital between May 2016 and December 2020 were screened after obtaining IRB approval. AKI was defined based on the AKI Network criteria. We investigated the incidence of clinical failure based on colistin dosing and AKI risk factors, such as the development of septic shock, severity of illness, and medication co-administration using a multiple logistic regression model. RESULTS: After screening 163 patients, 103 patients were included in the analysis. No difference was observed between the colistin dosing strategies for clinical failure. Of the included predictors, development of septic shock (OR: 3.75; 95% CI 1.18–13.15), carbapenem co-administration (OR, 3.96; 95% CI, 1.134–15.57) were associated with an increased risk of AKI. The other factors were not significant predictors. CONCLUSION: Clinical failure was not affected by colistin dosing strategies in our cohort of patients with sepsis. Moreover, the co-administration of carbapenems and the development of septic shock may increase the risk of inducing AKI in adult septic patients treated with IV colistin. Further studies are required to confirm these findings. |
format | Online Article Text |
id | pubmed-9048962 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-90489622022-04-29 Colistin Loading Dose in Septic Patients with Gram Negative Infections Alshaya, Abdulrahman I Bin Saleh, Khalid Aldhaeefi, Mohammed Baderldin, Hisham A Alamody, Farris O Alhamdan, Qusai A Almusallam, Mohammed A Alshaya, Omar Al Sulaiman, Khalid Alshareef, Shaima Alowais, Shuroug A Al Harbi, Shmeylan A Alghamdi, Ghassan Infect Drug Resist Original Research PURPOSE: Intravenous (IV) colistin is commonly used to treat multidrug-resistant gram-negative infections. It is primarily eliminated renally and may induce acute kidney injury (AKI) at a rate of up to 53%. Consequently, septic patients who require colistin administration have an additional risk of developing AKI. The aim of this study is to investigate clinical failure and AKI predictors for septic patients treated with IV colistin. METHODS: This retrospective cohort study was conducted at a tertiary teaching hospital in Saudi Arabia. Adult septic patients with suspected or confirmed gram-negative infections who received colistin admitted to the hospital between May 2016 and December 2020 were screened after obtaining IRB approval. AKI was defined based on the AKI Network criteria. We investigated the incidence of clinical failure based on colistin dosing and AKI risk factors, such as the development of septic shock, severity of illness, and medication co-administration using a multiple logistic regression model. RESULTS: After screening 163 patients, 103 patients were included in the analysis. No difference was observed between the colistin dosing strategies for clinical failure. Of the included predictors, development of septic shock (OR: 3.75; 95% CI 1.18–13.15), carbapenem co-administration (OR, 3.96; 95% CI, 1.134–15.57) were associated with an increased risk of AKI. The other factors were not significant predictors. CONCLUSION: Clinical failure was not affected by colistin dosing strategies in our cohort of patients with sepsis. Moreover, the co-administration of carbapenems and the development of septic shock may increase the risk of inducing AKI in adult septic patients treated with IV colistin. Further studies are required to confirm these findings. Dove 2022-04-24 /pmc/articles/PMC9048962/ /pubmed/35498632 http://dx.doi.org/10.2147/IDR.S361244 Text en © 2022 Alshaya et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Alshaya, Abdulrahman I Bin Saleh, Khalid Aldhaeefi, Mohammed Baderldin, Hisham A Alamody, Farris O Alhamdan, Qusai A Almusallam, Mohammed A Alshaya, Omar Al Sulaiman, Khalid Alshareef, Shaima Alowais, Shuroug A Al Harbi, Shmeylan A Alghamdi, Ghassan Colistin Loading Dose in Septic Patients with Gram Negative Infections |
title | Colistin Loading Dose in Septic Patients with Gram Negative Infections |
title_full | Colistin Loading Dose in Septic Patients with Gram Negative Infections |
title_fullStr | Colistin Loading Dose in Septic Patients with Gram Negative Infections |
title_full_unstemmed | Colistin Loading Dose in Septic Patients with Gram Negative Infections |
title_short | Colistin Loading Dose in Septic Patients with Gram Negative Infections |
title_sort | colistin loading dose in septic patients with gram negative infections |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048962/ https://www.ncbi.nlm.nih.gov/pubmed/35498632 http://dx.doi.org/10.2147/IDR.S361244 |
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