Earticle

초록

영어

Objective: Colistimethate was first became available in 1950s and used until the early 1980s to treat infections causedby gram-negative bacteria and was abandoned due to its nephrotoxicity and neurotoxicity. However, it was recently reintroducedinto the clinical practices due to emergence of multidrug-resistance gram-negative bacteria, particularlyPseudomonas aeruginosa and Acinetobacter baumanii. Therefore, it is increasingly used in the intensive care unit settingsas a salvage therapy. This study was designed to investigate the incidence rates and risk factors of acute kidneyinjury associated with colistimethate by using the standardized definition in critically ill patients. Methods: This studyretrospectively reviewed the electronic medical records of 71 adult patients above 18 years old receiving intravenouscolistimethate at least 48 hours at intensive care unit, university-affiliated hospital from Nov 2012 to Aug 2013 andexcluded patients with end-stage renal disease (ESRD) and required renal replacement therapy before initiation of thecolistimethate therapy. Acute kidney injury (AKI) was determined by using the standardized RIFLE criteria, classifiedwith risk, injury, failure, loss and ESRD according to serum creatinine (Scr) levels. Results: Among the 71 patientsincluded in the analysis, AKI developed in 40 patients (56.3%) and 6 patients (8.4%) had irreversible kidney injury. AKIoccurred within 5 days in 20 patients (50.0%). Maximum Scr level showed a significant increase in the patients with AKI(1.92±0.86 mg/dL vs. 1.12±0.46 mg/dL p=0.001), maximum BUN also increased (64.2±28.7 mg/dL vs. 48.4±24.9 mg/dLp=0.017) and minimum creatinine clearance (CLcr) was significantly decreased in the patients with AKI than non-AKI(34.5±18.6 ml/min vs. 64.4±33.7 ml/min p=0.185). The patients with AKI had significantly longer duration of colistimethatetherapy (21.1±17.0 days vs. 13.0±11.5 days, p=0.020) and larger cumulative doses of colistimethate (6465.9±4717.0 mg vs. 4438.1±3426.7 mg, p=0.040). Conclusion: The incidence and severity of AKI associated with colistimethatein critically ill patients was high and serious. Drug monitoring program should be performed to shorten durationof therapy and reduce cumulative dose from initiation of colistimethate therapy for minimizing AKI of colistimethate.

목차

Abstract
 연구 방법
  연구대상
  대상약물
  자료수집
  판정기준의 정의
  통계방법
 연구 결과
  대상환자의 특성
  급성 신손상 발현 비율 및 시기
  급성 신손상 위험인자 분석
 고찰
 결론
 참고문헌

키워드

저자

• 오명현 [ Myunghyun Oh | 숙명여자대학교 임상약학대학원 ]
• 방준석 [ Joon Seok Bang | 숙명여자대학교 임상약학대학원 ] Correspondence to

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  한국임상약학회지 [Korean Journal of Clinical Pharmacy]

• 간기

  계간

• pISSN

  1226-6051

• 수록기간

  1991~2026

• 등재여부

  KCI 등재

• 십진분류

  KDC 518 DDC 615