Prospective, comparative clinical study between high-dose colistin monotherapy and colistin-meropenem combination therapy for treatment of hospital-acquired pneumonia and ventilator-associated pneumonia caused by multidrug-resistant Klebsiella pneumoniae

Journal of Global Antimicrobial Resistance
Mohamed Farouk Ahmed AbdelsalamHanan Salah El-Din El-Abhar

Abstract

In clinical practice, colistin is used as combination therapy to improve its antibacterial activity, despite the consequent increase in toxicity. This prospective, comparative study evaluated the effectiveness and adverse effects of using colistin alone at a loading dose of 9 million international units (MIU) followed by 3 MIU every 8h (q8h) versus colistin+meropenem 1g q8h in treating multidrug-resistant (MDR) Klebsiella pneumoniae-induced hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). The primary outcome measure was in-hospital mortality. The secondary measure was the occurrence of colistin toxicity. A total of 60 patients were divided into two groups (30 patients each); the first group received intravenous colistin at a mean daily dose of 8.304 MIU and the second group received colistin 8.58 MIU combined with meropenem (mean daily dose of 2.88g for 15 days). The colistin-meropenem combination group showed a significant decrease in mortality versus colistin alone [16.7% (5/30) vs. 43.3% (13/30); P=0.047]. The improved clinical response mediated by combination therapy was not associated with any significant nephrotoxicity, hepatotoxicity or neurotoxicity. Moreover, the 42 surviving patients showed ...Continue Reading

Citations

Dec 29, 2020·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Florian WagenlehnerJason M Pogue
Mar 13, 2021·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Samir SamalDiganta Mohanty
Sep 19, 2020·European Journal of Microbiology & Immunology·Rasmus G BandickMarkus M Heimesaat
Oct 13, 2021·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Wen-Chia TsaiNan-Yao Lee

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carbapenems (ASM)

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

Carbapenems

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.