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Review
. 2023 Mar 10:16:1357-1366.
doi: 10.2147/IDR.S398930. eCollection 2023.

Adverse Events and Drug Resistance in Critically Ill Patients Treated with Colistimethate Sodium: A Review of the Literature

Victor Hugo Ahumada Topete #  1 , Kevin Jesus de Dios Sanchez #  1 , Gustavo Alejandro Casas Aparicio  2 , Graciela Hernandez Silva  2 , Cesar Emmanuel Lopez Vejar  1 , Luz Maria Torres Espíndola  3 , Arnoldo Aquino-Galvez  4 , Odalis Rodriguez Ganen  5 , Manuel de Jesus Castillejos Lopez  1
Affiliations
Review

Adverse Events and Drug Resistance in Critically Ill Patients Treated with Colistimethate Sodium: A Review of the Literature

Victor Hugo Ahumada Topete et al. Infect Drug Resist. .

Abstract

The adverse events related to sodium colistimethate have had variability regarding the prevalence of nephrotoxicity, neurotoxicity, and less frequent respiratory depression. In recent years, its use has been relevant due to the increase of multidrug-resistant bacteria since it is considered the last-line drug, being its main adverse event and reason for discrepancies between authors' nephrotoxicity. The indiscriminate use of antibiotic therapy has generated multiple mechanisms of resistance, the most common being related to Colistin, the bactericidal escape effect. Based on the search criteria, no randomized clinical trials were identified showing safety and efficacy with the use of Colistin, inferring that the application of the appropriate dose is governed by expert opinion and retrospective and prospective observational studies, which confounding factors such as the severity of the patient and the predisposition to develop acute renal failure are constant. In this review, we focus on identifying the mechanism of nephrotoxicity and bacterial resistance, where much remains to be known.

Keywords: colistimethate; colistin; high doses; multidrug-resistant gram-negative bacteria; nephrotoxicity; neurotoxicity; resistance mechanism; risk factors; toxicity.

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Conflict of interest statement

Victor Hugo Ahumada Topete and Kevin Jesus de Dios Sanchez are co-first authors for this study. The authors declare that they have no conflict of interest in this work.

Figures

Figure 1
Figure 1
Adverse events related to colistin. Created with BioRender.com.
Figure 2
Figure 2
The article search and selection flowchart is summarized.
See this image and copyright information in PMC

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