The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter Study
<i>Background and Objectives</i>: Bacterial infections amongst COVID-19 patients could be associated with worsened outcomes. This study aimed to investigate the efficacy of colistin antibiotic in multidrug-resistant (MDR) Gram-negative (-ve) secondary bacterial infections among hospitali...
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2025-05-01
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| author | Alzahraa M. Fahmy Marwa O. Elgendy Alaa Aboud Mohamed Mohamed S. Imam Abdullah Nasser Alharbi Muhammad Husayn Al-Anezi Omar Mana Aldhafeeri Saif Mamdouh Aldhafeeri Jawaher A. Ajeebi Marwa Kamal Hasnaa Osama |
| author_facet | Alzahraa M. Fahmy Marwa O. Elgendy Alaa Aboud Mohamed Mohamed S. Imam Abdullah Nasser Alharbi Muhammad Husayn Al-Anezi Omar Mana Aldhafeeri Saif Mamdouh Aldhafeeri Jawaher A. Ajeebi Marwa Kamal Hasnaa Osama |
| author_sort | Alzahraa M. Fahmy |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Bacterial infections amongst COVID-19 patients could be associated with worsened outcomes. This study aimed to investigate the efficacy of colistin antibiotic in multidrug-resistant (MDR) Gram-negative (-ve) secondary bacterial infections among hospitalized COVID-19 patients. <i>Materials and Methods</i>: In this multicentered retrospective study, we analyzed data from the medical records of 116 patients diagnosed with COVID-19 infection and secondary Gram-negative MDR bacterial respiratory infections. <i>Results</i>: We compared those assigned to colistin versus non-colistin-based antimicrobial therapy. The two arms of the study were similar in baseline clinical features, demographics, and Gram-negative pathogens’ distribution. Acinetobacter baumannii (51.7%) was the major pathogen, followed by Klebsiella pneumonia (26.7%). Patients who received colistin-based antimicrobial regimen showed a non-significant difference compared to non-colistin antimicrobial (NCA) therapy (<i>p</i> > 0.05) in the main outcomes. Nephrotoxicity was significantly higher in the IV colistin group, compared to the control (34.1% and 15.3%, <i>p</i> = 0.018). There were substantial differences observed in the levels of serum creatinine and urea among the study arms (<i>p</i> = 0.029 and <0.001, respectively). <i>Conclusions</i>: The combination of colistin with other antimicrobial agents showed comparable results to that of NCA regimens in hospitalized COVID-19 patients with superinfections with multidrug-resistant bacterial isolates; however, there was a notably elevated incidence of nephrotoxicity with colistin antimicrobial therapy. Further randomized controlled trials are needed to assess the therapeutic benefits and tolerability of colistin antimicrobial therapy. |
| format | Article |
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| institution | OA Journals |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-05-01 |
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| series | Medicina |
| spelling | doaj-art-2b8af4cc9077443a9dc136c8076b0c812025-08-20T02:33:51ZengMDPI AGMedicina1010-660X1648-91442025-05-0161588410.3390/medicina61050884The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter StudyAlzahraa M. Fahmy0Marwa O. Elgendy1Alaa Aboud Mohamed2Mohamed S. Imam3Abdullah Nasser Alharbi4Muhammad Husayn Al-Anezi5Omar Mana Aldhafeeri6Saif Mamdouh Aldhafeeri7Jawaher A. Ajeebi8Marwa Kamal9Hasnaa Osama10Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, EgyptDepartment of Clinical Pharmacy, Beni-Suef University Hospitals, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, EgyptDepartment of Tropical Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, EgyptDepartment of Clinical Pharmacy, National Cancer Institute, Cairo University, Fom El Khalig Square, Kasr Al-Aini Street, Cairo 11796, EgyptCollege of Pharmacy, Hafr Al Batin University, Hafr Al-Batin 31991, Saudi ArabiaCollege of Pharmacy, Hafr Al Batin University, Hafr Al-Batin 31991, Saudi ArabiaCollege of Pharmacy, Hafr Al Batin University, Hafr Al-Batin 31991, Saudi ArabiaCollege of Pharmacy, Hafr Al Batin University, Hafr Al-Batin 31991, Saudi ArabiaCollege of Pharmacy, Jazan University, Jazan 82912, Saudi ArabiaDepartment of Clinical Pharmacy, Faculty of Pharmacy, Fayoum University, Fayoum 63514, EgyptClinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt<i>Background and Objectives</i>: Bacterial infections amongst COVID-19 patients could be associated with worsened outcomes. This study aimed to investigate the efficacy of colistin antibiotic in multidrug-resistant (MDR) Gram-negative (-ve) secondary bacterial infections among hospitalized COVID-19 patients. <i>Materials and Methods</i>: In this multicentered retrospective study, we analyzed data from the medical records of 116 patients diagnosed with COVID-19 infection and secondary Gram-negative MDR bacterial respiratory infections. <i>Results</i>: We compared those assigned to colistin versus non-colistin-based antimicrobial therapy. The two arms of the study were similar in baseline clinical features, demographics, and Gram-negative pathogens’ distribution. Acinetobacter baumannii (51.7%) was the major pathogen, followed by Klebsiella pneumonia (26.7%). Patients who received colistin-based antimicrobial regimen showed a non-significant difference compared to non-colistin antimicrobial (NCA) therapy (<i>p</i> > 0.05) in the main outcomes. Nephrotoxicity was significantly higher in the IV colistin group, compared to the control (34.1% and 15.3%, <i>p</i> = 0.018). There were substantial differences observed in the levels of serum creatinine and urea among the study arms (<i>p</i> = 0.029 and <0.001, respectively). <i>Conclusions</i>: The combination of colistin with other antimicrobial agents showed comparable results to that of NCA regimens in hospitalized COVID-19 patients with superinfections with multidrug-resistant bacterial isolates; however, there was a notably elevated incidence of nephrotoxicity with colistin antimicrobial therapy. Further randomized controlled trials are needed to assess the therapeutic benefits and tolerability of colistin antimicrobial therapy.https://www.mdpi.com/1648-9144/61/5/884colistinCOVID-19Gram-negative bacteriasecondary infection |
| spellingShingle | Alzahraa M. Fahmy Marwa O. Elgendy Alaa Aboud Mohamed Mohamed S. Imam Abdullah Nasser Alharbi Muhammad Husayn Al-Anezi Omar Mana Aldhafeeri Saif Mamdouh Aldhafeeri Jawaher A. Ajeebi Marwa Kamal Hasnaa Osama The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter Study Medicina colistin COVID-19 Gram-negative bacteria secondary infection |
| title | The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter Study |
| title_full | The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter Study |
| title_fullStr | The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter Study |
| title_full_unstemmed | The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter Study |
| title_short | The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter Study |
| title_sort | efficacy and tolerability of colistin versus non colistin antimicrobial regimens among hospitalized covid 19 patients with multidrug resistant bacterial superinfection an observational multicenter study |
| topic | colistin COVID-19 Gram-negative bacteria secondary infection |
| url | https://www.mdpi.com/1648-9144/61/5/884 |
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