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Polimixin B use in treatment of multidrug-resistant Pseudomonas aeruginosa infection

Objective

To describe the use of polimixin B as treatment of multidrug-resistant (MDR) Pseudomonas aeruginosa infection.

Method

In this retrospective study we describe the features and demographic data of 27 patients with MDR P. aeruginosa treated with polimixin B, admitted to a private hospital medical and surgical intensive care unit (ICU).

Results

Twenty-three patients (85.2%) were infected with MDR P. aeruginosa, confirmed with cultures and resistance tests, during the ICU stay. In greater part, they were isolated from respiratory and urinary tract infections (33.3% and 25.9%, respectively). Four patients were treated empirically, with 50% of therapy response. The study group presented a mean age of 63 years, 51.9% males, with a mean Acute Physiology and Chronic Health Evaluation II score of 24.63. Sixty-three percent of our patients were first admitted to the hospital with community-acquired infection, none caused by P. aeruginosa. The most frequent cause for ICU admission was communitarian or nosocomial respiratory tract infection (29.9%). The mean time of polimixin B use was 15.59 days. Twelve patients (44%) used imipinem, 12 patients (44%) used teicoplanin and three patients (11%) used vancomicin, for more than 3 days, during the ICU stay before polimixin B use. After treatment with polimixin B, we had 40.7% response and improvement and 59.3% death.

Conclusion

After this series, we suggest that polimixin B can be a useful alternative for treatment of MDR P. aeruginosa infection.

References

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    Bukholm G, et al.: An outbreak of multidrug-resistant Pseudomonas aeruginosa associated with increased risk of patient death in an intensive care unit. Infect Control Hosp Epidemiol 2002, 23: 441-446.

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    Bertrand X, et al.: Pseudomonas aeruginosa : antibiotic susceptibility and genotypic characterization of strains isolated in the intensive care unit. Clin Microbiol Infect 2001, 7: 706-708. 10.1046/j.1198-743x.2001.00345.x

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Gouveia, L., Ribeiro-Neto, M., Ferreira, L. et al. Polimixin B use in treatment of multidrug-resistant Pseudomonas aeruginosa infection. Crit Care 7, P68 (2003). https://doi.org/10.1186/cc2264

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Keywords

  • Intensive Care Unit
  • Urinary Tract
  • Tract Infection
  • Respiratory Tract
  • Urinary Tract Infection