Journal of global antimicrobial resistance
-
J Glob Antimicrob Resist · Dec 2018
Randomized Controlled TrialProspective, comparative clinical study between high-dose colistin monotherapy and colistin-meropenem combination therapy for treatment of hospital-acquired pneumonia and ventilator-associated pneumonia caused by multidrug-resistant Klebsiella pneumoniae.
In clinical practice, colistin is used as combination therapy to improve its antibacterial activity, despite the consequent increase in toxicity. This prospective, comparative study evaluated the effectiveness and adverse effects of using colistin alone at a loading dose of 9 million international units (MIU) followed by 3 MIU every 8h (q8h) versus colistin+meropenem 1g q8h in treating multidrug-resistant (MDR) Klebsiella pneumoniae-induced hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). The primary outcome measure was in-hospital mortality. The secondary measure was the occurrence of colistin toxicity. ⋯ This study revealed the superiority of colistin-meropenem combination therapy over colistin monotherapy in the treatment of MDR K. pneumoniae-induced HAP or VAP and highlights the advantage of procalcitonin over CRP as a marker for eradication of sepsis and suspension of therapy.