The outcome of colistin use for the treatment of multidrug resistant acinetobacter baumanii in critically ill patients at a tertiary care center

Abstract

The prevalence of nosocomial infections caused by Multi-drug resistant gram negative bacteria (MDRGNB) has been dramatically increased in the past few decades. It was noted that despite the presence of wide range of commercial antibiotics that are intended to treat these types of infections, the emergent resistance and virulence of some gram negative bacterial species and strains had limited the clinicians choices and focused their attention towards the reintroduction of an old antibiotic (polymyxin E) discovered 50 years ago and was abandoned since then because of its questioned safety and efficacy.This study was conducted to display and examine with an eye to the differences between two types of treatments for gram negative bacteria. Currently, there is no avail-able study that rendered a formal statement about the meaningful impinging of colistin re use on patient’s outcomes especially those who acquired intensive care unit infection with pulmonary or blood stream multi drug resistant (MDR) acinetobacter species infec-tion.The aims of our study are to investigate whether the reintroduction of colistin into clinical practice to treat patients with MDR acinetobacter species have significantly improved the 30-days patient’s in-hospital stays compared to those patients who were treated with other used antibiotics and to question the resulting nephrotoxicity status in both groups.Retrospective cohort with external comparison group; Risk factors for mortality and nephrotoxicity were investigated in both the colistin and the non colistin group. The colistin group consisted of patients who were acinetobacter MDR and treated with in-travenous or inhaled or both intravenous-inhaled colistin with or without other combined antimicrobials. The non-colistin group included patients who were treated with combinations of antibiotics used to treat MDR acinetobacter baumanii. Both treatment groups were adjusted to the severity of illness by calculating the SOFA score within 24 hours of admission, Pittsburgh bacterem