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[Intravenous colistin in the treatment of infections due to pan-resistant Gram negative bacilli]. / Colistín en infecciones nosocomiales por bacilos gramnegativos pan-resistentes.
Fica C, Alberto; Céspedes J, Ignacio; Gompertz G, Macarena; Jalón V, Mauricio; Sakurada Z, Andrea; Sáez L, Enzo.
Afiliação
  • Fica C A; Sección de Infectología, Hospital Clínico Universidad de Chile, Santiago, Chile. afica@redclinicauchile.cl
Rev Chilena Infectol ; 24(5): 360-7, 2007 Oct.
Article em Es | MEDLINE | ID: mdl-17989839
UNLABELLED: Emergence of panresistant gram negative bacilli has lead to the progressive reintroduction of intravenous colistin. AIM: To describe the clinical experience observed with this compound. METHODOLOGY: A retrospective analysis was performed for all treatments lasting >/= 48 hours. Medical records were analyzed to obtain clinical parameters and microbiological data, evaluate clinical response and evolution until discharge. MAIN RESULTS: 24 treatments lasting >/= 48 hours were applied between June 2005 and September 2006. Intravenous colistin was indicated to treat cases of ventilator-associated (VA) pneumonia (n = 10; 41.7%), abscess or collections (12.5%), bloodstream infections, non-VA pneumonia or urinary tract infections (4.2% each one, respectively). Treatment was initiated on average at 3.2 days (+/- 2.85) from diagnosis of infection. All courses were microbiologically-guided, and involved P. aeruginosa or A. baumannii isolates. Susceptibility was evaluated by E-test in 11 isolates (MIC90 3.6 nicrog/mL, range 0.38 to 4 microg/mL). One isolate was resistant to colistin (9%). A favorable response was observed in 12 treatments (50%) with a relapse in 5 cases (41.7%). Being treated for pneumonia was the only factor associated to failure, (p = 0.04) Eradication was documented in 8 cases (33.3%) and persistence in 11 (45.8%). In 5 cases a microbiological follow-up was not available. Survival at time of discharge was 45.5%. (n = 10) None of the treatment courses was associated with nefrotoxicity. CONCLUSIONS: Intravenous colistin is a safe compound useful to treat various nosocomial infections due to pan-resistant gram negative bacilli. Nonetheless, its clinical efficacy is limited, especially among patients treated for nosocomial pneumonia.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pseudomonas aeruginosa / Infecções por Pseudomonas / Infecções por Acinetobacter / Colistina / Acinetobacter baumannii / Antibacterianos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: Es Revista: Rev Chilena Infectol Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Chile País de publicação: Chile
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pseudomonas aeruginosa / Infecções por Pseudomonas / Infecções por Acinetobacter / Colistina / Acinetobacter baumannii / Antibacterianos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: Es Revista: Rev Chilena Infectol Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Chile País de publicação: Chile