Factors Associated with Successful Treatment of Carbapenem-Resistant Gram-Negative Bacilli Infections Using Intravenous Colistin Sulfate in China: A Real-World Retrospective Study.

OBJECTIVE

To evaluate the efficacy of intravenous colistin sulfate (CS) in the treatment of carbapenem-resistant Gram-negative bacilli (CR-GNB) infections in real-world clinical settings and to identify factors influencing its therapeutic outcomes, with the aim of promoting the rational use of CS.

METHODS

A retrospective analysis was conducted on the clinical characteristics and treatment outcomes of 174 patients diagnosed with CR-GNB infection who received intravenous CS at our center between January 2021 and December 2023. The study evaluated both clinical efficacy and adverse drug reactions (ADRs).

RESULTS

Among the 174 patients, 118 cases (67.8%) demonstrated clinical improvement, and the bacterial clearance rate was 53.9%. Multivariate logistic regression analysis identified several factors significantly associated with treatment efficacy: neurological disease (OR [95% CI]: 0.100 [0.019-0.541]; = 0.006), admission to a surgical ward (OR [95% CI]: 0.136 [0.023-0.801]; = 0.027), septic shock (OR [95% CI]: 5.147 [1.901-14.096]; = 0.001), and empirical use of CS (OR [95% CI]: 4.250 [1.109-16.291]; = 0.035). Additionally, 10 cases (5.8%) of acute kidney injury (AKI) were attributed to nephrotoxicity from CS, with 2 cases recovering after discontinuation of the drug.

CONCLUSION

Our findings suggest that intravenous colistin sulfate may be an effective treatment option for CR-GNB infections when used appropriately. However, further studies are required to better understand its real-world efficacy and safety profile.