Luque Sonia, Sorli Luisa, Li Jian, Collado Silvia, Barbosa Francesc, Berenguer Nuria, Horcajada Juan Pablo, Grau Santiago
J Chemother. 2014 Apr;26(2):122-4. doi: 10.1179/1973947813Y.0000000104. Epub 2013 Dec 6.
Colistin use has reemerged for the treatment of infections caused by multidrug-resistant Gram-negative bacteria. However, the information on its pharmacokinetics is limited, especially in patients with end-stage renal disease, in which dosage adjustments are contradictory, and evidences the need to investigate the removal of colistin through renal replacement therapies like haemodialysis. This case study showed efficient removal of colistin methanesulphonate and formed colistin during intermittent haemodialysis in a patient infected by polymyxin-only-susceptible Pseudomonas aeruginosa. These results suggest the importance to monitor colistin plasma concentrations in these patients to minimize treatment failure due to suboptimal exposure to antibacterial colistin.
多粘菌素已重新用于治疗由多重耐药革兰氏阴性菌引起的感染。然而,关于其药代动力学的信息有限,尤其是在终末期肾病患者中,其剂量调整存在矛盾,这表明有必要研究通过血液透析等肾脏替代疗法清除多粘菌素。本病例研究表明,在一名仅对多粘菌素敏感的铜绿假单胞菌感染患者进行间歇性血液透析期间,多粘菌素甲磺酸盐和形成的多粘菌素能有效清除。这些结果表明,监测这些患者的多粘菌素血浆浓度对于尽量减少因抗菌多粘菌素暴露不足导致的治疗失败至关重要。