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Journal of Medical Microbiology logo Journal of Medical Microbiology

Volume 73, Issue 6

Colistin utilization at a tertiary hospital in South Africa: an opportunity for antimicrobial stewardship practices No Access

Abstract

Colistin (polymyxin E) has emerged as a last-resort treatment option for multidrug-resistant infections.

Studies on the use, safety and efficacy of colistin in South Africa are limited.

. This study aims to describe the use of colistin and its clinical outcomes at a tertiary public hospital in South Africa.

We conducted a retrospective review of adult and paediatric patients who received parenteral colistin between 2015 and 2019.

A total of 69 patients (26 adults, 13 children and 30 neonates) were reviewed. was the most common causative pathogen isolated (70.1 %). Colistin was predominately used to treat septicaemia (75.4 %). It was primarily administered as definitive therapy (71.0 %) and as monotherapy (56.5 %). It was used in 11.5 % of adults with infections susceptible to other antibiotics. Loading doses of intravenous colistin were administered in only 15 (57.7 %) adult patients. Neurotoxicity and nephrotoxicity occurred in 5.8 % and 43.5 % of patients, respectively. Clinical cure was achieved in 37 (53.6 %) patients. On multivariate logistic regression analysis, adults [adjusted odds ratio (aOR), 25.54; 95 % CI, 2.73–238.65; < 0.01] and children (aOR, 8.56; 95 % CI, 1.06–69.10; < 0.05) had higher odds of death than neonates.

The study identified significant stewardship opportunities to improve colistin prescription and administration. Achieving optimal patient outcomes necessitates a multidisciplinary approach and vigilant monitoring of colistin use.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): colistimethate sodium , mortality , multidrug resistance , nephrotoxicity , neurotoxicity and outcomes
© 2024 The Authors
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/content/journal/jmm/10.1099/jmm.0.001840
2024-06-06
2025-06-19
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/content/journal/jmm/10.1099/jmm.0.001840
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Colistin utilization at a tertiary hospital in South Africa: an opportunity for antimicrobial stewardship practices
J. Med. Microbiol. 73, 001840 (2024); https://doi.org/10.1099/jmm.0.001840
/content/journal/jmm/10.1099/jmm.0.001840
/content/journal/jmm/10.1099/jmm.0.001840
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