Use of parenteral colistin for the treatment of multiresistant Gram-negative organisms in major burn patients in South Korea

Purpose To assess the therapeutic effect and toxicity of intravenous colistin in the treatment of multidrug-resistant (MDR) Gram-negative bacteria in patients with severe burns. Methods The medical records of 930 patients admitted to the Burn Intensive Care Unit (ICU) at Hallym University Hangang Sa...

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Veröffentlicht in:Infection 2012-02, Vol.40 (1), p.27-33
Hauptverfasser: Cho, Y. S., Yim, H., Yang, H. T., Hur, J., Chun, W., Kim, J. H., Lee, B. C., Seo, D. K., Kim, D.
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container_end_page 33
container_issue 1
container_start_page 27
container_title Infection
container_volume 40
creator Cho, Y. S.
Yim, H.
Yang, H. T.
Hur, J.
Chun, W.
Kim, J. H.
Lee, B. C.
Seo, D. K.
Kim, D.
description Purpose To assess the therapeutic effect and toxicity of intravenous colistin in the treatment of multidrug-resistant (MDR) Gram-negative bacteria in patients with severe burns. Methods The medical records of 930 patients admitted to the Burn Intensive Care Unit (ICU) at Hallym University Hangang Sacred Heart Hospital, Seoul, South Korea between April 2007 and December 2009 were retrospectively reviewed. Of these, the 104 patients who had received intravenous colistin treatments (104 courses) during this period were enrolled in the study. Changes in creatinine level were analyzed in three groups: all patients receiving colistin ( n  = 104), patients with undergoing continuous renal replacement therapy (CRRT group; n  = 38), and patients not undergoing CRRT (non-CRRT group; n  = 66). Results Among these patients, the burnt body surface area ranged from 5 to 96% (mean 49.7%). Thirty-five patients (33.7%) suffered inhalation injury, and CRRT was administered to 38 patients. The mean duration of colistin treatment was 14.7 (range 4–71) days. The total dose of colistin was 3,045.7 mg (range 100–13,800). The length of ICU stay was 48.9 (range 7–154) days. Forty patients (38.5%) died. The mean pre-colistin creatinine level of all patients was 1.04 mg/dL, and the mean post-colistin level was 1.34 mg/dL. The mean pre-colistin creatinine level of the CRRT group and non-CRRT group was 1.68 and 0.66 mg/dL, and the mean post-colistin level was 1.68 and 1.14 mg/dL, respectively. Conclusions Colistin appears to be a relatively safe and effective treatment for major burn patients with infections caused by MDR Gram-negative bacteria when no other drug is available. Additionally, we found no statistically significant impairment of creatinine levels.
doi_str_mv 10.1007/s15010-011-0192-7
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S. ; Yim, H. ; Yang, H. T. ; Hur, J. ; Chun, W. ; Kim, J. H. ; Lee, B. C. ; Seo, D. K. ; Kim, D.</creator><creatorcontrib>Cho, Y. S. ; Yim, H. ; Yang, H. T. ; Hur, J. ; Chun, W. ; Kim, J. H. ; Lee, B. C. ; Seo, D. K. ; Kim, D.</creatorcontrib><description>Purpose To assess the therapeutic effect and toxicity of intravenous colistin in the treatment of multidrug-resistant (MDR) Gram-negative bacteria in patients with severe burns. Methods The medical records of 930 patients admitted to the Burn Intensive Care Unit (ICU) at Hallym University Hangang Sacred Heart Hospital, Seoul, South Korea between April 2007 and December 2009 were retrospectively reviewed. Of these, the 104 patients who had received intravenous colistin treatments (104 courses) during this period were enrolled in the study. Changes in creatinine level were analyzed in three groups: all patients receiving colistin ( n  = 104), patients with undergoing continuous renal replacement therapy (CRRT group; n  = 38), and patients not undergoing CRRT (non-CRRT group; n  = 66). Results Among these patients, the burnt body surface area ranged from 5 to 96% (mean 49.7%). Thirty-five patients (33.7%) suffered inhalation injury, and CRRT was administered to 38 patients. The mean duration of colistin treatment was 14.7 (range 4–71) days. The total dose of colistin was 3,045.7 mg (range 100–13,800). The length of ICU stay was 48.9 (range 7–154) days. Forty patients (38.5%) died. The mean pre-colistin creatinine level of all patients was 1.04 mg/dL, and the mean post-colistin level was 1.34 mg/dL. The mean pre-colistin creatinine level of the CRRT group and non-CRRT group was 1.68 and 0.66 mg/dL, and the mean post-colistin level was 1.68 and 1.14 mg/dL, respectively. Conclusions Colistin appears to be a relatively safe and effective treatment for major burn patients with infections caused by MDR Gram-negative bacteria when no other drug is available. Additionally, we found no statistically significant impairment of creatinine levels.</description><identifier>ISSN: 0300-8126</identifier><identifier>EISSN: 1439-0973</identifier><identifier>DOI: 10.1007/s15010-011-0192-7</identifier><identifier>PMID: 21898119</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Acinetobacter - isolation &amp; purification ; Acinetobacter Infections - drug therapy ; Acinetobacter Infections - microbiology ; Acinetobacter Infections - mortality ; Adult ; Aged, 80 and over ; Anti-Bacterial Agents - administration &amp; dosage ; Anti-Bacterial Agents - therapeutic use ; Bacteria ; Burn Units ; Burns - blood ; Burns - drug therapy ; Burns - microbiology ; Burns - mortality ; Child ; Clinical and Epidemiological Study ; Colistin - administration &amp; dosage ; Colistin - therapeutic use ; Creatinine - blood ; Drug Resistance, Multiple, Bacterial ; Family Medicine ; Female ; General Practice ; Humans ; Infectious Diseases ; Inhalation ; Internal Medicine ; Length of Stay ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Pseudomonas - isolation &amp; purification ; Pseudomonas Infections - drug therapy ; Pseudomonas Infections - microbiology ; Pseudomonas Infections - mortality ; Renal Replacement Therapy ; Republic of Korea ; Retrospective Studies ; Young Adult</subject><ispartof>Infection, 2012-02, Vol.40 (1), p.27-33</ispartof><rights>Springer-Verlag 2011</rights><rights>Springer-Verlag 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-99becfa3011fc70006d920cda61260bbb39d8bb01fd30e595f88038f6fc1527f3</citedby><cites>FETCH-LOGICAL-c511t-99becfa3011fc70006d920cda61260bbb39d8bb01fd30e595f88038f6fc1527f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s15010-011-0192-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s15010-011-0192-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21898119$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cho, Y. S.</creatorcontrib><creatorcontrib>Yim, H.</creatorcontrib><creatorcontrib>Yang, H. T.</creatorcontrib><creatorcontrib>Hur, J.</creatorcontrib><creatorcontrib>Chun, W.</creatorcontrib><creatorcontrib>Kim, J. H.</creatorcontrib><creatorcontrib>Lee, B. C.</creatorcontrib><creatorcontrib>Seo, D. K.</creatorcontrib><creatorcontrib>Kim, D.</creatorcontrib><title>Use of parenteral colistin for the treatment of multiresistant Gram-negative organisms in major burn patients in South Korea</title><title>Infection</title><addtitle>Infection</addtitle><addtitle>Infection</addtitle><description>Purpose To assess the therapeutic effect and toxicity of intravenous colistin in the treatment of multidrug-resistant (MDR) Gram-negative bacteria in patients with severe burns. Methods The medical records of 930 patients admitted to the Burn Intensive Care Unit (ICU) at Hallym University Hangang Sacred Heart Hospital, Seoul, South Korea between April 2007 and December 2009 were retrospectively reviewed. Of these, the 104 patients who had received intravenous colistin treatments (104 courses) during this period were enrolled in the study. Changes in creatinine level were analyzed in three groups: all patients receiving colistin ( n  = 104), patients with undergoing continuous renal replacement therapy (CRRT group; n  = 38), and patients not undergoing CRRT (non-CRRT group; n  = 66). Results Among these patients, the burnt body surface area ranged from 5 to 96% (mean 49.7%). Thirty-five patients (33.7%) suffered inhalation injury, and CRRT was administered to 38 patients. The mean duration of colistin treatment was 14.7 (range 4–71) days. The total dose of colistin was 3,045.7 mg (range 100–13,800). The length of ICU stay was 48.9 (range 7–154) days. Forty patients (38.5%) died. The mean pre-colistin creatinine level of all patients was 1.04 mg/dL, and the mean post-colistin level was 1.34 mg/dL. The mean pre-colistin creatinine level of the CRRT group and non-CRRT group was 1.68 and 0.66 mg/dL, and the mean post-colistin level was 1.68 and 1.14 mg/dL, respectively. Conclusions Colistin appears to be a relatively safe and effective treatment for major burn patients with infections caused by MDR Gram-negative bacteria when no other drug is available. 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S.</au><au>Yim, H.</au><au>Yang, H. T.</au><au>Hur, J.</au><au>Chun, W.</au><au>Kim, J. H.</au><au>Lee, B. C.</au><au>Seo, D. K.</au><au>Kim, D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of parenteral colistin for the treatment of multiresistant Gram-negative organisms in major burn patients in South Korea</atitle><jtitle>Infection</jtitle><stitle>Infection</stitle><addtitle>Infection</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>40</volume><issue>1</issue><spage>27</spage><epage>33</epage><pages>27-33</pages><issn>0300-8126</issn><eissn>1439-0973</eissn><abstract>Purpose To assess the therapeutic effect and toxicity of intravenous colistin in the treatment of multidrug-resistant (MDR) Gram-negative bacteria in patients with severe burns. Methods The medical records of 930 patients admitted to the Burn Intensive Care Unit (ICU) at Hallym University Hangang Sacred Heart Hospital, Seoul, South Korea between April 2007 and December 2009 were retrospectively reviewed. Of these, the 104 patients who had received intravenous colistin treatments (104 courses) during this period were enrolled in the study. Changes in creatinine level were analyzed in three groups: all patients receiving colistin ( n  = 104), patients with undergoing continuous renal replacement therapy (CRRT group; n  = 38), and patients not undergoing CRRT (non-CRRT group; n  = 66). Results Among these patients, the burnt body surface area ranged from 5 to 96% (mean 49.7%). Thirty-five patients (33.7%) suffered inhalation injury, and CRRT was administered to 38 patients. The mean duration of colistin treatment was 14.7 (range 4–71) days. The total dose of colistin was 3,045.7 mg (range 100–13,800). The length of ICU stay was 48.9 (range 7–154) days. Forty patients (38.5%) died. The mean pre-colistin creatinine level of all patients was 1.04 mg/dL, and the mean post-colistin level was 1.34 mg/dL. The mean pre-colistin creatinine level of the CRRT group and non-CRRT group was 1.68 and 0.66 mg/dL, and the mean post-colistin level was 1.68 and 1.14 mg/dL, respectively. Conclusions Colistin appears to be a relatively safe and effective treatment for major burn patients with infections caused by MDR Gram-negative bacteria when no other drug is available. Additionally, we found no statistically significant impairment of creatinine levels.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21898119</pmid><doi>10.1007/s15010-011-0192-7</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Acinetobacter - isolation & purification
Acinetobacter Infections - drug therapy
Acinetobacter Infections - microbiology
Acinetobacter Infections - mortality
Adult
Aged, 80 and over
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Bacteria
Burn Units
Burns - blood
Burns - drug therapy
Burns - microbiology
Burns - mortality
Child
Clinical and Epidemiological Study
Colistin - administration & dosage
Colistin - therapeutic use
Creatinine - blood
Drug Resistance, Multiple, Bacterial
Family Medicine
Female
General Practice
Humans
Infectious Diseases
Inhalation
Internal Medicine
Length of Stay
Male
Medicine
Medicine & Public Health
Middle Aged
Pseudomonas - isolation & purification
Pseudomonas Infections - drug therapy
Pseudomonas Infections - microbiology
Pseudomonas Infections - mortality
Renal Replacement Therapy
Republic of Korea
Retrospective Studies
Young Adult
title Use of parenteral colistin for the treatment of multiresistant Gram-negative organisms in major burn patients in South Korea
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