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Nephrotoxicity of intravenous colistin: a prospective evaluation

Abstract number: p1556

Falagas  M., Fragoulis  K., Kasiakou  S., Sermaides  G., Michalopoulos  A.

Objectives: 

Nephrotoxicity is the major concern arising with the use of intravenous colistimethate sodium.

Methods: 

A prospective cohort study was performed at "Henry Dunant" Hospital, a 450-bed tertiary care center in Athens, Greece. Patients who received intravenous colistin for at least 7 days for the treatment of multidrug resistant Gram-negative bacterial infections were included in the study. The development of nephrotoxicity through evaluations of serum creatinine, blood urea, serum electrolytes, urinalysis, and creatinine and sodium in 24-hour urine collection during intravenous colistin therapy was the primary end point of the study.

Results: 

Twenty-six patients were included in the study, 21 of whom received colistimethate sodium (CMS) for at least 7 days and were evaluated further. The mean (± SD)/median daily dose, cumulative dose, and duration of treatment of intravenous CMS was 5.5 (± 1.9)/6 million IU, 90.2 (±52.0)/72 million IU, and 17.7 (±11.7)/15 days (range 7–54 days), respectively. Three of the 21 evaluable patients (14.3%) developed nephrotoxicity during the intravenous treatment with CMS. The cumulative dose of the administered CMS was statistically correlated with the difference between the end and start of CMS treatment values of serum creatinine (r = 0.6, p = 0.004 by Spearman's test). A statistically but not clinically significant decrease of the mean baseline serum sodium concentration was observed between start and end of treatment [mean 144.2 (±6.9) to 142.1 (±6.1) mmol/L, p = 0.04]. No other toxic events were noted during the intravenous administration of colistimethate sodium.

Conclusion: 

Although this is an evaluation of a small number of patients, our prospective study shows that nephrotoxicity was not commonly observed in this group of patients who received intravenous colistimethate sodium. However, caution should be taken to avoid the prolonged administration of the antibiotic.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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