INT-005 A study of use of colistin in the emergency centre, clinical centre of serbia

Abstract

Background Colistin (polymyxin E) is a mixture of cyclic polypeptides colistin A and B, and is one of the last line of antibiotics for the treatment of multi-resistant strains of Pseudomonas aeruginosa and Acinetobacter spp. Drug is registreted in Serbia in 2014. Purpose In 2014 it was noticed increased use of colistin in relation to the previous years. The goal of this study is to analyse its usage due to increased bacterial resistance and difficulties in its supply. Material and methods By a retrospective descriptive study of patients treated with colistin from June to September 2014, we analysed number of patients, dosage, type of bacteria and the number of used ampoules per patients. Use of colistin was monitored in patients in intensive care units and departments of internal medicine and surgery at Emergency Centre. Results In this period, 36 patients were treated, and it was spent 1,631 ampoules. In 18 cases (50%) the posology was 1 MIU/8 h, in 16 cases (44.4%) the posology was 2 MIU/8 h and in 2 cases (5.6%) the posology was 2 MIU/8 h i.v and 1 MIU/8 h by inhalation. Colistin was used in the following units: intensive care units (89%), surgery (6%) and internal departments (5%). At 95% of patients, the drug was introduced in the therapy based on microbiological confirmation of infection with Pseudomonas aeruginosa (resistant to previous therapy with aminoglycosides and carbapenems) and multi-drug resistant strains of Acinetobacter spp. Empirically treatment was started in 5% of patients. Conclusion Due to the increased number of patients with severe intrahospital infections, it is necessary to establish strict control in the use of colistin (based on antibiograms hemoculture or cerebrospinal fluid). References and/or acknowledgements No conflict of interest.