Risk Factors for Mortality in Patients Treated with Colistin Monotherapy for Carbapenem-Resistant Acinetobacter...

Colistin is a critical antibiotic used to treat infections caused by carbapenem-resistant Gram-negative organisms, including carbapenem-resistant Acinetobacter baumannii (CRAB). However, its use is associated with significant morbidity and mortality. This study aimed to identify the risk factors for 30-day mortality in patients treated with colistin monotherapy for CRAB infections.

A retrospective cohort study was conducted at Nakornping Hospital, including adult patients treated with intravenous colistin monotherapy between January 2015 and October 2021. Univariate and multivariate analyses were performed to identify independent predictors of 30-day mortality.

A total of 223 patients were included in the study. The 30-day mortality rate was 37.22%. Univariate analysis found that age, malignancy, Charlson Comorbidity Index score, nephrotoxicity, mechanical ventilation, septic shock, and intensive care unit status were significantly associated with an increased risk of mortality. However, the total dose of colistin was associated with a decreased risk of mortality. In multivariate analysis, malignancy, nephrotoxicity, mechanical ventilation, and septic shock were significantly associated with an increased risk of mortality. Conversely, the total dose of colistin was associated with a decreased risk of mortality.

This study highlighted the importance of considering key risk factors in the management of CRAB infections treated with colistin monotherapy. Identifying patients at higher risk of mortality can guide treatment decisions and improve outcomes in this challenging population.