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Intensive Care Medicine
Published in: Intensive Care Medicine 7/2007

01-07-2007 | Original

Safety and efficacy of colistin compared with imipenem in the treatmentof ventilator-associated pneumonia: a matched case–control study

Authors: H. Kallel, L. Hergafi, M. Bahloul, A. Hakim, H. Dammak, H. Chelly, C. Ben Hamida, A. Chaari, N. Rekik, M. Bouaziz

Published in: Intensive Care Medicine | Issue 7/2007

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Abstract

Objective

Our study aimed to determine the efficacy and safety of colistin in the treatment of ventilator-associated pneumonia (VAP) caused by pan-drug-resistant Pseudomonas aeruginosa or Acinetobacter baumanii.

Design

Pairwise, retrospective exposed–unexposed study.

Setting

Combined medical and surgical intensive care unit of Habib Bourguiba University Hospital (Sfax, Tunisia).

Patients

Sixty patients with VAP caused by pan-drug-resistant A. baumanii or P. aeruginosa matched to 60 controls with VAP caused by A. baumanii or P. aeruginosa susceptible to imipenem. All patients had normal renal function at the onset of antibiotic therapy.

Interventions

Case patients were treated by colistin intravenously and control patients were treated by imipenem intravenously.

Measurements and results

Baseline characteristics were similar between the colistin and imipenem groups. The mean duration of antibiotic therapy for VAP was 9.5 ± 3.8 days (range 5–22 days) with colistin and 8.9 ± 2.8 days (range 5–20 days) with imipenem (p = 0.32). A favorable clinical response to antibiotic therapy for VAP occurred in 45 patients (75%) in the colistin group and in 43 patients (71.7%) in the imipenem group (p = 0.68). The time to resolution of infectious parameters after the initiation of antibiotic therapy was not statistically different between the two groups. During the antibiotic course, none of the patients in either group developed renal failure.

Conclusions

We conclude that colistin can be a safe and effective option in the treatments of VAP caused by pan-drug-resistant P. aeruginosa or A. baumanii.
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Metadata
Title
Safety and efficacy of colistin compared with imipenem in the treatmentof ventilator-associated pneumonia: a matched case–control study
Authors
H. Kallel
L. Hergafi
M. Bahloul
A. Hakim
H. Dammak
H. Chelly
C. Ben Hamida
A. Chaari
N. Rekik
M. Bouaziz
Publication date
01-07-2007
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 7/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-007-0675-2

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