Efficacy and Safety of the Treatment of Acinetobacter baumannii Infection with Colistin Injection
Article Sidebar
Main Article Content
Abstract
Objective: To study the clinical efficacy and nephrotoxicity from colistin injection in the treatment of Acinetobacter baumannii infected patients. Methods: The research was a descriptive study prospectively collecting the data from inpatient medical records of 49 patients receiving care from Vachiraphuket Hospital between June and September 2016, with diagnosis of A. baumannii infection and being treated with colistin injection. Result: Eighteen from 49 subjects were diagnosed with ventilator-associated pneumonia. Average duration of colistin injection was 10.6 days, Seventeen subjects had favorable clinical responses after treatment, while all cause death, no clinical responses and not able to determine the responses were observed in 9, 8 and 15 subjects, respectively. Subjects with colistin monotherapy (11 patients) had a better clinical response than those with combined therapy of colistin and other antibiotics (38 patients). Drug given with colistin and having the highest number of cured subjects was meropenem. Specimen culture at the end of treatment found no A. baumannii in 14 patients. Nephrotoxicity, adverse reaction from colistin, was found in 23 patients. Efficacy of treatment had no correlation with medical regimens, type of medicines or diseases. Conclusion: Colistin injection is still an appropriate regimen for treatment of A. baumannii infection. However, multidisciplinary team should closely monitor the occurrence of nephrotoxicity.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
2. National Antimicrobial Resistance Surveillance Center. Result of antimicrobial resistance surveil- lance [online]. 2007 [cited Jan 11, 2016]. Available from: narst.dmsc.moph.go.th
3. Fishbain J, Peleg A. Treatment of Acinetobacter infections. Clin Infect Dis 2010;51:79-84.
4. Koomanachai P, Tiengrim S, Kiratisin P, Thamlikit kul V. Efficacy and safety of colistin (colistimethate sodium) for therapy of infections caused by multi drug-resistant Pseudomonas aeruginosa and AcenI tobacter baumannii in Siriraj Hospital, Bangkok, Thailand. Int J Infect Dis 2007;11: 402-6.
5. Puttilerpong C, Chawanasith W, Laohawaleesan W, Rungsang W, Ritteeverakul P. Antimicrobial use in hospital-acquired pneumonia with multidrug-resis tant Acinetobacter baumannii at King Chulalong- korn Memorial Hospital. Thai Pharmaceutical and Health Science Journal 2011; 6: 32–8.
6. Chaiyasong C, Chaiyasong S. Outcome and costs of colistin and tigecycline for treatment of gram-nagative infections. Isan Journal of Pharmaceutical Sciences 2013; 9: 66-73.
7. Thamlikitkul V, Popum S. Monitoring of effective ness and safety of colistin for therapy in resistant gram-negative bacterial infections in hospitalized patients at Siriraj Hospital. J Med Assoc Thai 2016; 99: 301-7.
8. Gilbert DN, Chambers HF, Eliopoulos GM, Saag MS, Pavia AT, Black D, et al. The Sanford guide line to antimicrobial therapy 2016. 46th ed. Sperry ville: Antimicrobial Therapy Inc.; 2016.
9. Kellum JA, Lameire N, Aspelin P, Macleod AM, Barsoum RS, Mehta RL, et al. Kidney disease improving global outcomes (KDIGO) clinical prac tice guideline for acute kidney injury. Kidney Inter Suppl 2012;2: 8-12.
