Acinetobacter multidrug-resistant

Jimenez-Mejias ME, Pichardo-Guerrero C, Marquez-Rivas FJ, Martin-Lozano D, Prados T, Pachon J. Cerebrospinal fluid penetration and pharmacokinetic/phar-macodynamic parameters of intravenously administered colistin in a case of multidrug-resistant Acinetobacter bau-mannii meningitis. Eur J CUn Microbiol Infect Dis 2002 21(3) 212-14. 

Multidrug-resistant Pseudomonas and Acinetobacter infections are of concern to clinicians because of the limited therapeutic options available for the treatment of such infections. This concern has led... 

Levin AS, Barone AA, Penco J, et al. Intravenous coUstin therapy for nosocomial infecUons caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumarmii. CUn Infect Dis 1999 28 1008-1011. 

A probable hypersensitivity pneumonitis secondary to inhaled aerosolized coUstin has been reported in a 68-year-old Indian woman who was successfully treated for a nosocomial pneumonia due to a multidrug-resistant Acinetobacter baumarmii [100 ]. The authors postulated that the hypersensitivity pneumonitis was due to conversion of the prodrug, colistimethate, to the biologically active form of colistin, which is less well tolerated. They recommended ensuring that the prodrug is only reconstituted just before administration to avoid excessive conversion to the biologically active drug. 

In a prospective case series of the use of cohstimethate for multidrug-resistant nosocomial infections caused by Pseudomonas aeruginosa or Acinetobacter baumannii in 15 children, one developed renal insufficiency that resolved after withdrawal [109 ]. 

A retrospective matched case-control study was carried out to determine the effect of inhaled colistin (160 mg twice daily) in patients with multidrug resistant Acinetobacter baumannii infection. The majority of patients reviewed were intensive care patients with baseline renal impairment. After 28 days of treatment, 17.9% developed haemodynamic instability, 30.6% developed acute renal failure and 20.8% required intubation. These results were not different to the control group and highlight the poor clinical state of the patient rather than the antibiotic used [137 ]. 

Kuo SC, Lee YT, Yang SP, Chen CP, Chen TL, Hsieh SL, et al. Eradication of multidrug-resistant Acinetobacter baumannii from the respiratory tract with inhaled colistin methanesulfonate a matched case-control study. Clin Microbiol Infect 2012 18(9) 870-6. 

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