Colistin-associated nephrotoxicity among patients in intensive care units (ICU) of hospitals in Selangor
- Author:
Rashizal Sazli Mohd Rasidin
;
Ami Fazlin Syed Mohamed
;
Wan Mazuan Wan Mahmud
;
Ling Siew Mei
;
Aidalina Mahmud
;
Syafinaz Amin Nordin
- Publication Type:Journal Article
- Keywords:
Colistin;
Intensive care units;
acute kidney injury;
Acinetobacter baumannii;
retrospective studies
- MeSH:
Colistin;
Intensive Care Units
- From:
The Medical Journal of Malaysia
2017;72(2):100-105
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The increasing trend of extensively drugresistant
gram negative bacteria responsible for nosocomial
infections has prompted resurgence colistin usage.
Colistin-induced nephrotoxicity is a concern with disparity
in the reported rates between previous studies. This study
aims to evaluate colistin-induced nephrotoxicity among
Malaysian population.
Methods: The medical records of ICU patients receiving
colistin therapy in Hospital Serdang and Hospital Sungai
Buloh from 2010 to 2012 were retrospectively reviewed.
Demographics data, treatment characteristic as well as
culture result and creatinine level were documented.
Nephrotoxicity was determined based on RIFLE criteria.
Results: A total of 100 patients were included. Median daily
dose, cumulative dose and duration of colistin therapy were
3.0 MIU (IQR: 4, range 1-12), 17.8 MIU (IQR: 31.5, range 2-180)
and seven days (IQR: 4, range 1-30). Nephrotoxicity was
found in 23% of the study population. All cases were
reversible but marginally associated with higher mortality.
No statistical association exist between age, gender and
race as well as administration routes with nephrotoxicity by
univariable analysis. The association of dose and duration
with nephrotoxicity was also not significant by univariable
analysis. After adjustment for confounders, statistical
association between the independent variables and
dependent variable remains not significant.
Conclusion: Lower dose and shorter duration in local
settings contribute to lack of association between colistin
therapy and nephrotoxicity in this study. Higher dosing
regimen with loading dose application has been introduced
in the latest National Antibiotic Guideline. Further
evaluation of colistin-induced nephrotoxicity and potential
risk factors is therefore warranted.
- Full text:P020170509420870879285.pdf
