Abstract
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.
| Original language | English |
|---|---|
| Article number | e0207588 |
| Journal | PloS one |
| Volume | 13 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2018 Nov 1 |
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All Science Journal Classification (ASJC) codes
- Biochemistry, Genetics and Molecular Biology(all)
- Agricultural and Biological Sciences(all)
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Risk factors of colistin safety according to administration routes : Intravenous and aerosolized colistin. / Min, Kyoung Lok; Son, Eun Sun; Kim, Jae Song; Kim, Soo Hyun; Jung, Sun Mi; Chang, Min Jung.
In: PloS one, Vol. 13, No. 11, e0207588, 01.11.2018.Research output: Contribution to journal › Article
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
PY - 2018/11/1
Y1 - 2018/11/1
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.
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U2 - 10.1371/journal.pone.0207588
DO - 10.1371/journal.pone.0207588
M3 - Article
VL - 13
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 11
M1 - e0207588
ER -