The Effect of Different Colistin Dosing Regimens on Nephrotoxicity : A Cohort Study

(1) Background: It is not known whether different daily dosing schemes have different effects on colistin nephrotoxicity. We examined the effect of once- versus twice- or thrice-daily doses of colistin on renal function. (2) Methods: We performed a multicenter retrospective cohort study of hospitalized patients with a baseline glomerular filtration rate ≥ 50 mL/min who received intravenously the same colistin dose once (regimen A), twice (regimen B) or thrice daily (regimen C). The primary endpoint was acute kidney injury (AKI), defined as fulfilment of any of the RIFLE (Risk-Injury-Failure-Loss-End stage renal disease) criteria. (3) Results: We included 306 patients; 132 (43.1%) received regimen A, 151 (49.3%) regimen B, and 23 (7.5%) regimen C. Ninety-nine (32.4%) patients developed AKI; there was no difference between regimen A vs. B and C [45 (34.1%) vs. 54 (31.0%), p = 0.57]. In a propensity score−matched cohort, AKI was similar in patients receiving Regimen A, Regimen B, and Regimen C (31.6% vs. 33.3%, p = 0.78). On logistic regression analysis, diabetes was an independent predictor of AKI (OR = 4.59, 95% CI 2.03−10.39, p = 0.001) while eGFR > 80 mL/min (OR = 0.50, 95% CI 0.25−0.99, p = 0.048) was inversely associated with AKI. (4) Conclusions: Colistin once daily is not more nephrotoxic than the standard colistin regimens. The only independent predictor of nephrotoxicity was diabetes mellitus, while eGFR > 80 mL/min had a protective effect.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:11

Enthalten in:

Antibiotics (Basel, Switzerland) - 11(2022), 8 vom: 05. Aug.

Sprache:

Englisch

Beteiligte Personen:

Samarkos, Michael [VerfasserIn]
Papanikolaou, Konstantinos [VerfasserIn]
Sourdi, Athena [VerfasserIn]
Paisios, Nikolaos [VerfasserIn]
Mainas, Efstratios [VerfasserIn]
Paramythiotou, Elisabeth [VerfasserIn]
Antoniadou, Anastasia [VerfasserIn]
Sambatakou, Helen [VerfasserIn]
Gargalianos-Kakolyris, Panayiotis [VerfasserIn]
Skoutelis, Athanasios [VerfasserIn]
Daikos, George L [VerfasserIn]

Links:

Volltext

Themen:

Acute kidney injury
Colistin
Journal Article
Nephrotoxicity
Pharmacokinetics/pharmacodynamics
RIFLE

Anmerkungen:

Date Revised 08.03.2023

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.3390/antibiotics11081066

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM345283295