TY - JOUR
T1 - Risk factors of colistin safety according to administration routes
T2 - Intravenous and aerosolized colistin
AU - Min, Kyoung Lok
AU - Son, Eun Sun
AU - Kim, Jae Song
AU - Kim, Soo Hyun
AU - Jung, Sun Mi
AU - Chang, Min Jung
N1 - Publisher Copyright:
© 2018 Min et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/11
Y1 - 2018/11
N2 - Background Nephrotoxicity of intravenous (IV) colistin has impeded its clinical use; aerosolized (AS) colistin may be an alternative, but safety data are lacking. Therefore, this study aimed to evaluate the incidence of acute kidney injury (AKI) and risk factors associated with IV and AS colistin administration. Methods A retrospective study was performed in a tertiary referral hospital. Data were collected before and after colistin administration between October 2012 and April 2016. Exclusion criteria were as follows: age less than 18 years, previous colistin administration, concurrent use of IV and AS colistin, dialysis before colistin use, and colistin use for less than 3 days. We compared AKI incidence following administration of IV versus AS colistin and analyzed risk factors for colistin-associated nephrotoxicity. Results A total of 464 patients were enrolled (n = 311, IV group; n = 153, AS group). Incidence of AKI was significantly higher in the IV group (IV vs AS, 20.26% vs 7.84%, p-value < 0.001). Duration of colistin use (OR 1.033, 95% CI 1.009–1.058, p-value 0.008) and presence of chronic kidney disease (OR 2.710, 95% CI 1.348–5.448, p-value 0.005) were associated with nephrotoxicity. There were no significant risk factors associated with AS colistin. Conclusions Although AS colistin was not associated with any significant risk factors for nephrotoxicity, duration of colistin use and baseline kidney function may affect AS colistin-associated nephrotoxicity.
AB - Background Nephrotoxicity of intravenous (IV) colistin has impeded its clinical use; aerosolized (AS) colistin may be an alternative, but safety data are lacking. Therefore, this study aimed to evaluate the incidence of acute kidney injury (AKI) and risk factors associated with IV and AS colistin administration. Methods A retrospective study was performed in a tertiary referral hospital. Data were collected before and after colistin administration between October 2012 and April 2016. Exclusion criteria were as follows: age less than 18 years, previous colistin administration, concurrent use of IV and AS colistin, dialysis before colistin use, and colistin use for less than 3 days. We compared AKI incidence following administration of IV versus AS colistin and analyzed risk factors for colistin-associated nephrotoxicity. Results A total of 464 patients were enrolled (n = 311, IV group; n = 153, AS group). Incidence of AKI was significantly higher in the IV group (IV vs AS, 20.26% vs 7.84%, p-value < 0.001). Duration of colistin use (OR 1.033, 95% CI 1.009–1.058, p-value 0.008) and presence of chronic kidney disease (OR 2.710, 95% CI 1.348–5.448, p-value 0.005) were associated with nephrotoxicity. There were no significant risk factors associated with AS colistin. Conclusions Although AS colistin was not associated with any significant risk factors for nephrotoxicity, duration of colistin use and baseline kidney function may affect AS colistin-associated nephrotoxicity.
UR - http://www.scopus.com/inward/record.url?scp=85056983279&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056983279&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0207588
DO - 10.1371/journal.pone.0207588
M3 - Article
C2 - 30462703
AN - SCOPUS:85056983279
VL - 13
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 11
M1 - e0207588
ER -