Comparison of colistin monotherapy and non-colistin combinations in the treatment of multi-drug resistant Acinetobacter spp. bloodstream infections: a multicenter retrospective analysis

To compare the efficacy of colistin (COL) monotherapy versus non-COL based combinations in the treatment of bloodstream infections (BSIs) due to multidrug resistant Acinetobacter spp.(MDR-A). Retrospective data of 107 MDR-A BSI cases from 27 tertiary centers in Turkey were included. 14-day mortality...

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Bibliographic Details
Published in:Indian journal of pharmacology 2015-01, Vol.47 (1), p.95-100
Main Authors: Balkan, Ilker Inanc, Batirel, Ayse, Karabay, Oguz, Agalar, Canan, Akalin, Serife, Alici, Ozlem, Alp, Emine, Altay, Fatma Aybala, Altin, Nilgun, Arslan, Ferhat, Aslan, Turan, Bekiroglu, Nural, Cesur, Salih, Celik, Aygul Dogan, Dogan, Mustafa, Durdu, Bulent, Duygu, Fazilet, Engin, Aynur, Engin, Derya Ozturk, Gonen, Ibak, Guclu, Ertugrul, Guven, Tumer, Hatipoglu, Cigdem Ataman, Hosoglu, Salih, Karahocagil, Mustafa Kasim, Kilic, Aysegul Ulu, Ormen, Bahar, Ozdemir, Davut, Ozer, Serdar, Oztoprak, Nefise, Sezak, Nurbanu, Turhan, Vedat, Turker, Nesrin, Yilmaz, Hava
Format: Article
Language:English
Subjects:
Acinetobacter
Acinetobacter - drug effects
Acinetobacter - pathogenicity
Acinetobacter Infections - drug therapy
Acinetobacter Infections - microbiology
Acinetobacter Infections - mortality
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - therapeutic use
Antibiotics
APACHE
Bacteremia - drug therapy
Bacteremia - microbiology
Bacteremia - mortality
Bacterial infections
Blood
Chi-Square Distribution
Colistin - adverse effects
Colistin - therapeutic use
Combination drug therapy
Comorbidity
Comparative analysis
Comparative studies
Drug resistance
Drug Resistance, Multiple, Bacterial
Drug Therapy, Combination
Female
Health aspects
Host-parasite relationships
Humans
Kaplan-Meier Estimate
Length of Stay
Male
Middle Aged
Multivariate Analysis
Pharmacology
Prevention
Proportional Hazards Models
Remission Induction
Retrospective Studies
Risk Factors
Tertiary Care Centers
Time Factors
Treatment Outcome
Turkey
Young Adult
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Summary:To compare the efficacy of colistin (COL) monotherapy versus non-COL based combinations in the treatment of bloodstream infections (BSIs) due to multidrug resistant Acinetobacter spp.(MDR-A). Retrospective data of 107 MDR-A BSI cases from 27 tertiary centers in Turkey were included. 14-day mortality. Microbial eradication and clinical improvement. Thirty-six patients in the COL monotherapy (CM) group and 71 in the non-COL based combinations (NCC) group were included in the study. Mean age was 59.98 ± 20 years (range: 18-89) and 50.5% were male. Median duration of follow-up was 40 days (range: 9-297). The 14-day survival rates were 52.8% in CM and 47.23% in NCC group (P = 0.36). Microbiological eradication was achieved in 69% of CM and 83% of NCC group (P = 0.13). Treatment failure was detected in 22.9% of cases in both CM and NCC groups. Univariate analysis revealed that mean age (P = 0.001), Charlson comorbidity index (P = 0.03), duration of hospital stay before MDR-A BSI (P = 0.04), Pitt bacteremia score (P = 0.043) and Acute Physiology and Chronic Health Evaluation II score (P = 0.05) were significant in terms of 14-day mortality. Advanced age (P = 0.01) and duration of hospital stay before MDR-A BSI (P = 0.04) were independently associated with 14-day mortality in multivariate analysis. No significant difference was detected between CM and non-COL based combinations in the treatment of MDR-A BSIs in terms of efficacy and 14-day mortality.
ISSN:0253-7613
1998-3751
DOI:10.4103/0253-7613.150383