Nefrotoxicity Caused by Colistin Use: A Single Center Experience

Abstract

Abstract Aim In resistant infections and septic patients, the choice of colistin in the selection of antibiotic therapy is important in the treatment response. Kidney damage is common after antibiotic use. In our study, we evaluated the clinical and laboratory data of the patients who developed nephrotoxicity after the use of colistin, followed in the intensive care unit of our hospital. Material and Methods The clinical and laboratory characteristics and treatment results of 148 patients (54 nephrotoxic patients) with infection who were followed up in the intensive care unit (ICU) of our hospital evaluated. Results The group that developed nephrotoxicity was older [70.5 (40–91), p < 0.001]. The APACHE II score was higher in the nephrotoxicity group [20.5 (5–49), p = 0.004]. Positive inotrope use and mortality were higher in the nephrotoxicity group [32 (59.3%), p < 0.001 and 30 (55.6%), p = 0.004]. The duration of colistin use was longer in the nephrotoxicity group [13.5 (3–36), p = 0.045]. In the group that developed nephrotoxicity, the highest growth was detected in the tracheal aspirate (TAS) [49 (90.7%), p = 0.045]. Positive inotrope use and growth in TAS culture predisposed the development of nephrotoxicity in multivariate analysis [3.12 (1.38–7.02), CI 95%, p = 0.006, 5.70 (1.64–19.79), CI 95%, p = 0.006]. Conclusion Consideration should be given to the use of colistin in resistant infections and septic patients in terms of nephrotoxicity and mortality. Antibiotic selection should be considered in critically ill patients, and patients should be closely monitored.