Resident, Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India.
Tutor, Department of Biostatistics, Christian Medical College, Vellore, India.
Trop Doct. 2021 Jul;51(3):301-306. doi: 10.1177/0049475520987777. Epub 2021 Jan 24.
Multidrug-resistant Gram-negative bacterial infection is a serious global concern and especially in low and middle-income countries (LMIC) such as India. Colistin, an antimicrobial once abandoned following reports of organ toxicity, has re-emerged as an essential therapeutic agent in the management of these infections. A retrospective review of 162 inpatients was done, focusing on culture-proven multidrug-resistant infections requiring colistin. The overall clinical outcome in 58% of patients was found to be good, with nephrotoxicity and neurotoxicity occurring only in 8 (5%) and 4 (2.5%) patients, respectively. Multivariate analysis revealed an elevated lactate and raised urea to be independent factors associated with poor clinical response. In conclusion, there appears to be strong evidence supporting the use of colistin in the management of multidrug-resistant Gram-negative bacterial infections.
多重耐药革兰氏阴性菌感染是一个严重的全球性问题，尤其是在印度等中低收入国家（LMIC）。多粘菌素，一种曾因器官毒性报道而被弃用的抗菌药物，在治疗这些感染方面重新成为一种重要的治疗药物。对 162 名住院患者进行了回顾性分析，重点是培养证实的需要多粘菌素治疗的多重耐药感染。结果发现 58%的患者临床疗效良好，只有 8 名（5%）和 4 名（2.5%）患者分别出现肾毒性和神经毒性。多变量分析显示，乳酸升高和尿素升高是与临床反应不良相关的独立因素。总之，有强有力的证据支持使用多粘菌素治疗多重耐药革兰氏阴性菌感染。
