Huang Jie, Tang Yao-Qing, Sun Jing-Yong
Shanghai Jiaotong University, Shanghai, China.
Scand J Infect Dis. 2010 Apr;42(4):260-5. doi: 10.3109/00365540903490018.
In recent reports polymyxins have been considered an effective and safe treatment option for the management of multidrug-resistant (MDR) Gram-negative bacterial infections. Here we report our clinical experience with the use of intravenous colistin sulfate in critically ill patients hospitalized from January 2006 to October 2008, as a last treatment resort in China, and assess its effectiveness and adverse effects. Fifteen patients who suffered from severe infections caused by MDR or pandrug-resistant (PDR) Gram-negative bacteria (13 isolates of Acinetobacter baumannii, 4 isolates of Pseudomonas aeruginosa and 2 isolates of Klebsiella pneumoniae), unresponsive to the initial empirical regimens, were treated with colistin sulfate (daily dose of 1.28 +/- 0.25 million IU and duration of 22.3 +/- 6.2 days), based on sensitivity results. The treatment resulted in a good clinical response in 73.3%, microbiological clearance in 60% and mortality in 20%. Possible nephrotoxicity occurred in 1 patient and no patients developed neurotoxicity. In conclusion, intravenous colistin sulfate is a safe and viable alternative for the treatment of severe infections due to sensitive MDR Gram-negative bacteria.
在最近的报告中，多粘菌素被认为是治疗多重耐药（MDR）革兰氏阴性菌感染的一种有效且安全的治疗选择。在此，我们报告2006年1月至2008年10月在中国住院的重症患者使用静脉注射硫酸多粘菌素的临床经验，这是作为最后的治疗手段，并评估其有效性和不良反应。15例由MDR或泛耐药（PDR）革兰氏阴性菌引起严重感染的患者（13株鲍曼不动杆菌、4株铜绿假单胞菌和2株肺炎克雷伯菌），对初始经验性治疗方案无反应，根据药敏结果接受硫酸多粘菌素治疗（日剂量128±25万IU，疗程22.3±6.2天）。治疗后临床反应良好率为73.3%，微生物清除率为60%，死亡率为20%。1例患者出现可能的肾毒性，无患者发生神经毒性。总之，静脉注射硫酸多粘菌素是治疗由敏感MDR革兰氏阴性菌引起的严重感染的一种安全可行的替代方法。
