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Tytuł:
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Use of colistin in adult patients: A cross-sectional study.
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Autorzy:
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Giacobbe DR; Department of Health Sciences, University of Genoa, Genoa, Italy. Electronic address: .
Saffioti C; Department of Health Sciences, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino-IRCCS, Genoa, Italy.
Losito AR; Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Rinaldi M; Department of Medical and Surgical Sciences, Infectious Diseases Unit, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
Aurilio C; Anaesthesia and Intensive Care Unit, Department of Women, Children, General and Specialistic Surgery, L. Vanvitelli University of Campania, Naples, Italy.
Bolla C; SC Malattie Infettive, ASO SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Boni S; Divisione di Malattie Infettive, Ospedale Sant'Andrea, La Spezia, Italy.
Borgia G; Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Carannante N; First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, Naples, Italy.
Cassola G; Department of Infectious Diseases, Galliera Hospital, Genoa, Italy.
Ceccarelli G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
Corcione S; Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy.
Dalla Gasperina D; Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
De Rosa FG; Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy.
Dentone C; Medical Department, Infectious Diseases Unit, Sanremo Hospital, Imperia, Italy.
Di Bella S; Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
Di Lauria N; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Feasi M; Department of Infectious Diseases, Galliera Hospital, Genoa, Italy.
Fiore M; Department of Anaesthesiological, Surgical and Emergency Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Fossati S; Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
Franceschini E; Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy.
Gori A; University of Milan and Infectious Diseases Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Granata G; Clinical and Research Department for Infectious Diseases, Severe and Immunedepression-Associated Infections Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
Grignolo S; Divisione di Malattie Infettive, Ospedale Sant'Andrea, La Spezia, Italy.
Grossi PA; Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Guadagnino G; Infectious Diseases ISMETT IRCCS, Palermo, Italy.
Lagi F; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
Maraolo AE; Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Marinò V; IRCCS INM Neuromed, Pozzilli, Italy.
Mazzitelli M; Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
Mularoni A; Infectious Diseases ISMETT IRCCS, Palermo, Italy.
Oliva A; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy; IRCCS INM Neuromed, Pozzilli, Italy.
Pace MC; Department of Anaesthesiological, Surgical and Emergency Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Parisini A; SC Malattie Infettive, ASO SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Patti F; Medical Department, Infectious Diseases Unit, Sanremo Hospital, Imperia, Italy.
Petrosillo N; Clinical and Research Department for Infectious Diseases, Severe and Immunedepression-Associated Infections Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy.
Pota V; Anaesthesia and Intensive Care Unit, Department of Women, Children, General and Specialistic Surgery, L. Vanvitelli University of Campania, Naples, Italy.
Raffaelli F; Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Rossi M; Clinic of Infectious Diseases, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
Santoro A; Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy.
Tascini C; First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, Naples, Italy.
Torti C; Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
Trecarichi EM; Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
Venditti M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
Viale P; Department of Medical and Surgical Sciences, Infectious Diseases Unit, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
Signori A; Department of Health Sciences, University of Genoa, Genoa, Italy.
Bassetti M; Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata, Udine, Italy.
Del Bono V; Infectious Diseases Unit, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy.
Giannella M; Department of Medical and Surgical Sciences, Infectious Diseases Unit, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
Mikulska M; Department of Health Sciences, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino-IRCCS, Genoa, Italy.
Tumbarello M; Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Viscoli C; Department of Health Sciences, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino-IRCCS, Genoa, Italy.
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Corporate Authors:
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SITA GIOVANI (Young Investigators Group of the Società Italiana Terapia Antinfettiva) and the COLI-CROSS Study Group
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Źródło:
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Journal of global antimicrobial resistance [J Glob Antimicrob Resist] 2020 Mar; Vol. 20, pp. 43-49. Date of Electronic Publication: 2019 Jun 15.
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Typ publikacji:
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Journal Article; Observational Study; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: Amsterdam : Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer
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MeSH Terms:
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Drug Resistance, Multiple, Bacterial*
Anti-Bacterial Agents/*administration & dosage
Colistin/*administration & dosage
Gram-Negative Bacterial Infections/*drug therapy
Respiratory Tract Infections/*drug therapy
Sepsis/*drug therapy
Administration, Intravenous ; Aged ; Anti-Bacterial Agents/therapeutic use ; Colistin/therapeutic use ; Cross-Sectional Studies ; Drug Prescriptions/statistics & numerical data ; Drug Therapy, Combination/statistics & numerical data ; Endemic Diseases ; Female ; Gram-Negative Bacterial Infections/epidemiology ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Respiratory Tract Infections/microbiology ; Sepsis/microbiology
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Contributed Indexing:
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Keywords: Acinetobacter; Antimicrobial resistance; Colistimethate; Colistin; Klebsiella; Pseudomonas
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Substance Nomenclature:
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0 (Anti-Bacterial Agents)
Z67X93HJG1 (Colistin)
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Entry Date(s):
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Date Created: 20190618 Date Completed: 20210322 Latest Revision: 20210322
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Update Code:
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20240104
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DOI:
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10.1016/j.jgar.2019.06.009
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PMID:
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31207379
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Objectives: The aim of this study was to assess colistin use in a country endemic for multidrug-resistant Gram-negative bacteria (MDR-GNB).
Methods: Colistin prescription patterns were evaluated in 22 Italian centres. Factors associated with use of colistin in combination with other anti-MDR-GNB agents were also assessed.
Results: A total of 221 adults receiving colistin were included in the study. Their median age was 64 years (interquartile range 52-73 years) and 134 (61%) were male. Colistin was mostly administered intravenously (203/221; 92%) and mainly for targeted therapy (168/221; 76%). The most frequent indications for colistin therapy were bloodstream infection and lower respiratory tract infection. Intravenous colistin was administered in combination with at least another anti-MDR-GNB agent in 80% of cases (163/203). A loading dose of 9 MU of colistimethate was administered in 79% of patients receiving i.v. colistin and adequate maintenance doses in 85%. In multivariable analysis, empirical therapy [odds ratio (OR) = 3.25, 95% confidence interval (CI) 1.24-8.53;P = 0.017] and targeted therapy for carbapenem-resistant Enterobacterales infection (OR = 4.76, 95% CI 1.69-13.43; P = 0.003) were associated with use of colistin in combination with other agents, whilst chronic renal failure (OR = 0.39, 95% CI 0.17-0.88; P = 0.024) was associated with use of colistin monotherapy.
Conclusion: Colistin remains an important option for severe MDR-GNB infections when other treatments are not available. Despite inherent difficulties in optimising its use owing to peculiar pharmacokinetic/pharmacodynamic characteristics, colistin was mostly used appropriately in a country endemic for MDR-GNB.
(Copyright © 2019 International Society for Antimicrobial Chemotherapy. Published by Elsevier Ltd. All rights reserved.)
