TABLE 3.
The treatment methods of polymyxin E sulfate and outcomes based on different clinical responses.
| Variables | Total | Favorable clinical response (n = 64, 53.8%) | Unfavorable clinical response (n = 55, 46.2%) | P-value |
| Timing of medicationa (%) | ||||
| >24 h post culture positive | 57(47.9%) | 29(45.3%) | 28(50.9%) | 0.829 |
| <24 h post culture positive | 25(21%) | 14(21.9%) | 11(20.0%) | |
| Before CRO reported | 37(31.1%) | 21(32.8%) | 16(29.1%) | |
| Administration method (%) | ||||
| IV | 62(52.1%) | 29(45.3%) | 33(60.0%) | 0.119 |
| IH | 3(2.5%) | 3(4.7%) | 0(0.0%) | |
| IV + IH | 48(40.3%) | 27(42.2%) | 21(38.2%) | |
| IV + IVT | 6(5.0%) | 5(7.8%) | 1(1.8%) | |
| First dose administration (%) | ||||
| Noneb | 80(67.2%) | 49(76.6%) | 31(56.4%) | 0.065 |
| Additionc | 26(21.8%) | 10(15.6%) | 16(29.1%) | |
| Doubledd | 13(10.9%) | 5(7.8%) | 8(14.5%) | |
| Treatment course, median (range) | 11(7–16) | 13(10–17.75) | 9(5–14) | 0.000 |
| ≤7 days (%) | 32(26.9%) | 8(12.5%) | 24(43.6%) |
0.000 |
| 8–14 days (%) | 54(45.4%) | 33(51.6%) | 21(38.2%) | |
| >14 days (%) | 33(27.7%) | 23(35.9%) | 10(18.2%) | |
| Daily dose of IV, median (range) | 150(150–150) | 150(150–150) | 150(150–150) | 0.717 |
| Cumulative dose of IV, median (range) | 1350(900–2000) | 1700(1056.25–2250) | 950(525–1825) | 0.000 |
| Types of co-administratione (%) | ||||
| Monotherapy combination therapy | 8(6.7%) | 7(10.9%) | 1(1.8%) | 0.979 |
| 1 type of other agents | 63(52.9%) | 30(46.9%) | 33(60%) | |
| 2 types of other agents | 41(34.5%) | 22(34.4%) | 19(34.5%) | |
| ≥3 types of other agents | 7(5.9%) | 5(7.8%) | 2(3.6%) | |
| Outcome (%) | ||||
| In-hospital mortality | 33(27.7%) | 12(18.8%) | 21(38.2%) | 0.018 |
| Patients occurred with AKIf | 6(9.2%) | 3(7.7%) | 3(11.5%) | 0.930 |
| Valid microbiological responseg | 53(49.1%) | 38(62.3%) | 15(31.9%) | 0.002 |
CRO, carbapenem-resistant organisms; AKI, acute kidney injury; IV, intravenously guttae; IH, inhalation; IVT, intraventricular injection.
aTiming of colistin sulfate dosing before and after the identification of CRO. 37 patients were administrated with colistin sulfate before CRO reported, and only 11 patients were lack of positive bacterial culture results.
bThe first dose is not a loading dose.
cThe loading dose is less than two times the maintenance dose.
dThe loading dose is two times the maintenance dose.
eOther antimicrobial drugs used in conjunction with PES therapy, include tigecycline, carbapenems, β-lactamase inhibitor conjugates, aminoglycosides, quinolones, fosfomycin, aztreonam, etc.
fFifty-four patients were excluded due to undergoing continuous renal replacement therapy (CRRT) before dosing or on CRRT without nephrotoxicity during drug administration, with CKD or baseline eGFR < 60 ml/min per 1.73 m2.
gEleven patients were excluded due to empirical therapy without positive bacterial culture results.