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Comparison of colistin-induced nephrotoxicity between two different formulations of colistin in critically ill patients: a retrospective cohort study.


ABSTRACT:

Background

Colistin is widely used in the treatment of nosocomial infections caused by carbapenem-resistant gram-negative bacilli (CR-GNB). Colistin-induced nephrotoxicity is one of the major adverse reactions during colistin treatment. Comparisons of colistin-induced nephrotoxicity between different formulations of colistin are rarely reported.

Methods

In this retrospective cohort study, we enrolled intensive care unit-admitted patients if they had culture isolates of CR-GNB and underwent intravenous treatment with colistin. The occurrence of acute kidney injury (AKI) during intravenous treatment with colistin was recorded. The occurrence of colistin-induced nephrotoxicity was compared between two formulations of colistin, Locolin®, and Colimycin®. Treatment outcomes associated with the occurrence of colistin-induced nephrotoxicity were also investigated.

Results

Among 195 patients, 95 who were treated with Locolin® and 100 who were treated with Colimycin® were included for analysis. Patients treated with Locolin® had a higher rate of occurrence of stage 2 (46.3% vs. 32%, p = 0.040) and stage 3 (29.5% vs. 13%, p = 0.005) AKI than did those treated with Colimycin®. In multivariate analysis, the presence of septic shock (adjusted odds ratio [aOR] 2.17, 95% confidence interval [CI] 1.10-4.26) and inappropriate colistin dosage (aOR 2.52, 95% CI 1.00-6.33) were clinical factors associated with colistin-induced nephrotoxicity. Treatment with Colimycin® was an independent factor associated with a lower risk of colistin-induced nephrotoxicity (aOR 0.37, 95% CI 0.18-0.77). The mortality rate was comparable between patients with and without colistin-induced nephrotoxicity.

Conclusions

The risk of colistin-induced nephrotoxicity significantly varied in different formulations of colistin in critically ill patients. Colistin-induced nephrotoxicity was not associated with increased mortality rate.

SUBMITTER: Feng JY 

PROVIDER: S-EPMC8323087 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Publications

Comparison of colistin-induced nephrotoxicity between two different formulations of colistin in critically ill patients: a retrospective cohort study.

Feng Jia-Yih JY   Lee Yi-Tzu YT   Pan Sheng-Wei SW   Yang Kuang-Yao KY   Chen Yuh-Min YM   Yen David Hung-Tsang DH   Li Szu-Yuan SY   Wang Fu-Der FD  

Antimicrobial resistance and infection control 20210730 1


<h4>Background</h4>Colistin is widely used in the treatment of nosocomial infections caused by carbapenem-resistant gram-negative bacilli (CR-GNB). Colistin-induced nephrotoxicity is one of the major adverse reactions during colistin treatment. Comparisons of colistin-induced nephrotoxicity between different formulations of colistin are rarely reported.<h4>Methods</h4>In this retrospective cohort study, we enrolled intensive care unit-admitted patients if they had culture isolates of CR-GNB and  ...[more]

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