Colistin utilization at a tertiary hospital in South Africa: an opportunity for antimicrobial stewardship practices.
J Med Microbiol
; 73(6)2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38842435
ABSTRACT
Introduction. Colistin (polymyxin E) has emerged as a last-resort treatment option for multidrug-resistant infections.Hypothesis/Gap Statement. Studies on the use, safety and efficacy of colistin in South Africa are limited.Aim. This study aims to describe the use of colistin and its clinical outcomes at a tertiary public hospital in South Africa.Methodology. We conducted a retrospective review of adult and paediatric patients who received parenteral colistin between 2015 and 2019.Results. A total of 69 patients (26 adults, 13 children and 30 neonates) were reviewed. Acinetobacter baumannii was the most common causative pathogen isolated (70.1â%). Colistin was predominately used to treat septicaemia (75.4â%). It was primarily administered as definitive therapy (71.0â%) and as monotherapy (56.5â%). It was used in 11.5â% of adults with infections susceptible to other antibiotics. Loading doses of intravenous colistin were administered in only 15 (57.7â%) adult patients. Neurotoxicity and nephrotoxicity occurred in 5.8â% and 43.5â% of patients, respectively. Clinical cure was achieved in 37 (53.6â%) patients. On multivariate logistic regression analysis, adults [adjusted odds ratio (aOR), 25.54; 95â% CI, 2.73-238.65; P < 0.01] and children (aOR, 8.56; 95â% CI, 1.06-69.10; P < 0.05) had higher odds of death than neonates.Conclusion. The study identified significant stewardship opportunities to improve colistin prescription and administration. Achieving optimal patient outcomes necessitates a multidisciplinary approach and vigilant monitoring of colistin use.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Colistina
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Centros de Atenção Terciária
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Gestão de Antimicrobianos
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Antibacterianos
Limite:
Adolescent
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Adult
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Aged
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article