다제내성 Acinetobacter baumannii균에서 Tigecycline과 Colistin 치료 후의 임상 결과 평가
Evaluation of Clinical outcomes after Tigecycline and Colistin Treatment against Multidrug-resistant Acinetobacter baumannii
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Cases of multidrug-resistant Acinetobacter baumannii (MRAB) infection are increasing worldwide. Therapeutic options are limited, and these include tigecycline and colistin. However, few comparative studies have assessed the clinical effectiveness of these antibiotics. The aim of this study was to compare and evaluate the efficacy and safety of tigecycline and colistin in the treatment of an MRAB infection in order to generate optimal drug information. We retrospectively examined the electronic medical records of patients admitted to tertiary hospitals between January 2014 and March 2015. Patients were injected with colistin (colistimethate sodium) or tigecycline for at least 14 consecutive days intravenously. Data were obtained from blood samples taken at baseline and after 14days in order to evaluate the clinical efficacy and safety of these antibiotics. Eighty-four patients were treated with 50-100 mg of tigecycline per day (n=45) and 75-300 mg of colistin per day (n=39). The most frequent indications for treatment were skin and soft infection in the tigecycline group and pneumonia in the colistin group. Both antibiotics significantly decreased serum C-reactive protein (tigecycline vs. colistin = -3.4 ± 5.7 vs. -5.4 ± 7.5 mg/dL, p<0.05). The colistin group showed an elevated serum creatinine percentage of 74.4% when compared with the tigecycline group (p=0.031), which had 51.1%,; the tigecycline group showed a decrease in their platelet count having 62.2%, when compared with the colistin group which had 41.0%. No further statistically significant differences in clinical outcomes between the two groups were observed. Tigecycline and colistin are available treatment options for multidrug-resistant A. baumannii. These drugs have different adverse effects therefore, it is important to use the appropriate drug according to the patient’s clinical condition.
Abstract
Cases of multidrug-resistant Acinetobacter baumannii (MRAB) infection are increasing worldwide. Therapeutic options are limited, and these include tigecycline and colistin. However, few comparative studies have assessed the clinical effectiveness of these antibiotics. The aim of this study was to compare and evaluate the efficacy and safety of tigecycline and colistin in the treatment of an MRAB infection in order to generate optimal drug information. We retrospectively examined the electronic medical records of patients admitted to tertiary hospitals between January 2014 and March 2015. Patients were injected with colistin (colistimethate sodium) or tigecycline for at least 14 consecutive days intravenously. Data were obtained from blood samples taken at baseline and after 14days in order to evaluate the clinical efficacy and safety of these antibiotics. Eighty-four patients were treated with 50-100 mg of tigecycline per day (n=45) and 75-300 mg of colistin per day (n=39). The most frequent indications for treatment were skin and soft infection in the tigecycline group and pneumonia in the colistin group. Both antibiotics significantly decreased serum C-reactive protein (tigecycline vs. colistin = -3.4 ± 5.7 vs. -5.4 ± 7.5 mg/dL, p<0.05). The colistin group showed an elevated serum creatinine percentage of 74.4% when compared with the tigecycline group (p=0.031), which had 51.1%,; the tigecycline group showed a decrease in their platelet count having 62.2%, when compared with the colistin group which had 41.0%. No further statistically significant differences in clinical outcomes between the two groups were observed. Tigecycline and colistin are available treatment options for multidrug-resistant A. baumannii. These drugs have different adverse effects therefore, it is important to use the appropriate drug according to the patient’s clinical condition.
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