Akademik Veri Yönetim Sistemi
33rd International Congress of Antimicrobial Chemotherapy (ICC), İstanbul, Türkiye, 3 - 06 Kasım 2024, ss.5, (Özet Bildiri)
AIM: To compare polymyxin B with colistimethate sodium (CMS)
regarding neurotoxicity, nephrotoxicity, and 30-day mortality in
patients with multi-drug resistant (MDR) gram-negative.
BACKGROUND: The most significant adverse events of polymyxins
are neurotoxicity and nephrotoxicity.
METHODS: All adult patients who received polymyxin B or CMS
for at least 24 hours for the MDR microorganisms were evaluated
retrospectively.
RESULTS: Among 413 patients, 147 patients who were conscious
and able to express their symptoms were included in the neurotoxicity
analysis. 13 of 77 patients with polymyxin B and 1 of 70 with
CMS had neurotoxic adverse events, mainly paresthesias. All events
were reversible after drug discontinuation. Among 290 patients included
in nephrotoxicity analysis, the incidence of acute kidney
injury (AKI) was 44.7% and 40.0% for polymyxin B and CMS. AKI
occurred two days earlier with colistin than polymyxin B without
statistical significance. Polymyxin therapy was withdrawn in 41.1%
of patients after AKI occurred and CMS was more frequently withdrawn
than polymyxin B. AKI was reversible in 91.6% of patients
with CMS and 79% with polymyxin B after the drug withdrawal.
Older age, higher baseline serum creatinine, and the use of at least
two nephrotoxic drugs were independent factors associated with
AKI. The type of polymyxin was not related to mortality.
CONCLUSIONS: Neurotoxicity is a relatively common adverse event
during polymyxins, particularly polymyxin B. Nephrotoxicity is
very common during polymyxin and the two polymyxins display
similar nephrotoxic events with high reversibility rates after drug
withdrawal. Close monitoring of AKI is crucial during polymyxin
therapy.