Renal and neurological side effects of colistin in critically ill patients 英文参考文献.docVIP

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Renal and neurological side effects of colistin in critically ill patients 英文参考文献.doc

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Renal and neurological side effects of colistin in critically ill patients 英文参考文献

Spapenetal.AnnalsofIntensiveCare2011,1:14 /content/1/1/14 REVIEW OpenAccess Renalandneurologicalsideeffectsofcolistinin criticallyillpatients HerbertSpapen*,RitaJacobs,ViolaVanGorp,JorisTroubleynandPatrickMHonoré Abstract ColistinisacomplexpolypeptideantibioticcomposedmainlyofcolistinAandB.Itwasabandonedfromclinical useinthe1970sbecauseofsignificantrenaland,toalesserextent,neurologicaltoxicity.Actually,colistinis increasinglyputforwardassalvageorevenfirst-linetreatmentforseveremultidrug-resistant,Gram-negative bacterialinfections,particularlyintheintensivecaresetting.Wereviewedthemostrecentliteratureoncolistin treatment,focusingonefficacyandtoxicityissues.ThemethodusedforliteraturesearchwasbasedonaPubMed retrievalusingveryprecisecriteria. Despitelargevariationsindoseandduration,colistintreatmentproducesrelativelyhighclinicalcurerates.Colistin ispotentiallynephrotoxicbutcurrentlyusedcriteriatendtooverestimatetheincidenceofkidneyinjury. Nephrotoxicityindependentlypredictsfewercuresofinfectionandincreasedmortality.Totalcumulativecolistin doseisassociatedwithkidneydamage,suggestingthatshorteningoftreatmentdurationcoulddecreasethe incidenceofnephrotoxicity.Factorsthatmayenhancecolistinnephrotoxicity(i.e.,shock,hypoalbuminemia, concomitantuseofpotentiallynephrotoxicdrugs)mustbecombatedorcontrolled.Neurotoxicitydoesnotseem tobeamajorissueduringcolistintreatment.Abetterknowledgeofcolistinpharmacokineticsincriticallyill patientsisimperativeforobtainingcolistindosingregimensthatensuremaximalantibacterialactivityatminimal toxicity. Introduction reporting data on efficacy, nephrotoxicity, and neuro- Colistinbelongstothepolymyxinclassofcationicpoly- toxicity.Atotalof26relevantstudies[2-27]wereiden- peptide antibiotics. It is administered as the prodrug tifiedandaresummarizedinTable1. colistimethate sodium (CMS), a fraction of which is hydrolyzed in vivo to colistin. During the 1970s, the Patientcharacteristics popularityofcolistinrapidlyfadedbecauseofreportsof Them