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- Title
Comparison between Colistin and Polymyxin B in the Treatment of Bloodstream Infections Caused by Carbapenem-Resistant Pseudomonas aeruginosa and Acinetobacter baumannii-calcoaceticus Complex.
- Authors
Garcia, Rebeca Carvalho Lacerda; Rodrigues, Rodrigo Douglas; Garcia, Ester Carvalho Lacerda; Rigatto, Maria Helena
- Abstract
Polymyxins are still widely used for the treatment of carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa bloodstream infections (BSIs). This study seeks to evaluate the impact of polymyxin B versus colistin on mortality and nephrotoxicity in BSI caused by these bacteria. We conducted a retrospective cohort study from 2014 to 2021 in Porto Alegre, Brazil. We included patients aged ≥18 years and excluded patients with polymicrobial infection or treatment for ≤48 h. The 30-day mortality was the primary outcome evaluated through Cox regression. We included 259 patients with BSI episodes: 78.8% caused by A. baumannii and 21.2% caused by P. aeruginosa. Polymyxin B did not impact mortality compared to colistin (adjusted hazard ratio (aHR), 0.82; 95% confidence interval (CI), 0.52–1.30; p = 0.40 (when adjusted for COVID-19 comorbidity, p = 0.05), Pitt bacteremia score, p < 0.01; Charlson comorbidity index, p < 0.001; time to start active antimicrobial therapy, p = 0.02). Results were maintained in the subgroups of BSI caused by A. baumannii (aHR, 0.92; 95% CI, 0.55–1.54; p = 0.74), P. aeruginosa (aHR, 0.47; 95% CI, 0.17–1.32; p = 0.15) and critical care patients (aHR, 0.77; 95% CI, 0.47–1.26; p = 0.30). Treatment with polymyxin B or colistin did not impact 30-day mortality in patients with carbapenem-resistant A. baumannii or P. aeruginosa BSI.
- Subjects
PORTO Alegre (Brazil); POLYMYXIN B; CARBAPENEM-resistant bacteria; PSEUDOMONAS aeruginosa; PSEUDOMONAS aeruginosa infections; COLISTIN
- Publication
Antibiotics (2079-6382), 2023, Vol 12, Issue 8, p1317
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics12081317