EVALUATION OF VARIABILITY BETWEEN INTRAVENOUS COLISTIN THERAPY INVESTIGATIONS IN CURRENT LITERATURE

Atrium

Objective. To evaluate inconsistencies regarding colistin publications. Background. Due to the progression of antimicrobial resistance, colistin is being used more in clinical practice; however, discrepancies in data reporting have led to much confusion. Methods. Scopus and PubMed databases were accessed August 28, 2013. Queries incorporated the following limits: publication date between January 1990 and July 2013, human subjects, English language and abstract available. Keywords used were: colistin and colistimethate. Publications not reporting original research or outcome data for a cohort of adult patients who received intravenous colistin treatment were excluded. Results. Electronic queries provided 2,021 studies and 51 met inclusion criteria. Studies originated from 21 unique countries, with the United States and Greece being most frequent. The study medication was referred to as colistin, CMS (colistimethate sodium), and CBA (colistin base activity) in 25, 16, and 6 studies, respectively. Articles reporting colistin used IU or mg 88% of the time while 2 did not report units. For articles reporting CMS, 10 used IU and 5 used mg. Variability was present for comorbidity indices employed, nephrotoxicity definitions, and mortality endpoints. APACHE II was most frequently measured (n=33). Nephrotoxicity and mortality rates ranged from 0% to 57% and 20% to 62%, respectively. Conclusion. Extensive variability exists between studies of intravenous colistin from across the globe, complicating translation of outcomes into usable data for making clinical decisions. Future investigations of this nature must address such barriers to produce results pertinent to global health in this era of bad bugs, no drugs. Grants. N/A