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Nephrotoxicity prevalence in patients treated with polymyxins: a systematic review with meta-analysis of

Ana F Oliota1, Suelem T Penteado1, Fernanda S Tonin2

  • 1Center for Medical and Pharmaceutical Sciences, Universidade Estadual do Oeste do Paraná, Cascavel, Brazil.

Diagnostic Microbiology and Infectious Disease
|January 13, 2019
PubMed

Insights

Colistin and polymyxin B, crucial antibiotics for gram-negative infections, show similar nephrotoxicity rates. Factors like study year and renal damage criteria influence these adverse event rates.

Area of Science:

  • Pharmacology and Toxicology
  • Infectious Diseases
  • Nephrology

Background:

  • Colistin and polymyxin B are vital for treating multidrug-resistant gram-negative bacterial infections.
  • Growing resistance necessitates a thorough understanding of polymyxin characteristics, particularly nephrotoxicity.

Purpose of the Study:

  • To systematically review and meta-analyze cohort studies to determine the prevalence of nephrotoxicity in patients treated with colistin or polymyxin B.
  • To synthesize current evidence on polymyxin-induced renal damage.

Main Methods:

  • Systematic review and meta-analysis of observational cohort studies.
  • Searches of PubMed, Scopus, and DOAJ databases, supplemented by manual searches.
  • Inclusion of studies evaluating renal damage in adult patients treated with colistin or polymyxin B.

Main Results:

  • Analysis included 95 cohorts comprising 7911 patients.
  • Nephrotoxicity prevalence was 26.7% for colistin and 29.8% for polymyxin B (P=0.720).
  • Publication year, renal damage classification criteria, and outcome reporting (primary/secondary) significantly impacted nephrotoxicity rates.

Conclusions:

  • Colistin and polymyxin B exhibit comparable nephrotoxicity prevalence.
  • Variability in nephrotoxicity reporting is influenced by study design and classification methods.
Keywords:
NephrotoxicityPolymyxinsPrevalenceRenal failureSystematic reviewToxicity

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