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Sentences for "colistin "
aeruginosa and Acinetobacter baumannii strains in our ICU prompted us to try treatment with colistin as a last resort in patients with serious infections with such strains.
Here we report 3 years of experience with intravenous colistin in the treatment of Gram-negative sepsis.
baumannii that were resistant to all antibiotics apart from colistin, intravenous colistin sulfomethate sodium (Colistin, Norma, Athens, Greece) was initiated at the discretion of the attending physician.
Susceptibility to colistin was tested using the disk diffusion method, with a 10 µg colistin disk (Oxoid Ltd, Basingstoke, Hants, UK).
In 16 cases colistin was part of the initial empiric regimen based on previous surveillance cultures, with subsequent cultures confirming the sensitivity pattern.
A total of 26 courses of colistin were given, for the following infections: VAP (15 cases), empyema thoracis (one case), post-traumatic meningitis (one case), sinusitis (one case), urinary tract infection (one case), catheter-related sepsis (three cases), and sepsis of unknown primary origin (four cases).
Median duration of treatment with colistin was 13.
In the subgroup of patients with bacteremia (11 patients), an initial clinical response to colistin was observed in seven patients and the ICU mortality was 54.
Additional blood culture data after initiation of colistin were available in two of the clinical responders, and bacterial eradication was confirmed in both.
Three patients had already developed acute renal failure at the initiation of treatment with colistin and were being treated with continuous venovenous hemodiafiltration (CVVHD).
Discussion Colistin is a cationic polypeptide antibiotic of the polymyxin family that is rapidly bactericidal to Gram-negative bacteria.
The action of colistin is by a detergent-like mechanism, interfering with the structure and function of the outer cytoplasmic membrane of bacteria and resulting in bacterial death [ 11 13 ] .
It is administered as colistin sulfomethate sodium and its hydrolysis releases the active drug.
In recent years intravenous colistin has occasionally been used in acute exacerbations of multiresistant P.
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