colistin and Pyelonephritis

Multidrug resistant Gram-negative rods are emerging as major pathogens and are the cause of difficulty to treat infections. In certain situations colistin is the only active drug.. A retrospective review of the patient's charts admitted at Hôtel-Dieu de France hospital, Beirut, between October 2002 and February 2004 and treated with intravenous colistin.. Fifteen patients were identified; they were suffering from urinary tract infections, cellulitis, osteomyelitis, mediastinitis and intra-abdominal abscess. The microorganisms were resistant to all available antibiotics except colistin. Three strains were also susceptible to aminoglycosides. Pseudomonas aeruginosa was the most frequently isolated pathogen. Colistin was used in monotherapy in 12 patients and combined with amikacin in three patients. At the end of therapy, a 93% rate of favorable clinical outcome was observed. Renal toxicity was encountered among 12 patients. It was severe in only two cases in which creatinine clearance decline surpassed 50% of the baseline value. No neurological toxicity was observed.. Colistin has an important role to play when used for the treatment of infections with multiresistant Gram-negative bacteria. Nephrotoxicity seems much lower than expected and neurotoxicity is minimal.

Topics: Abdominal Abscess; Anti-Bacterial Agents; Colistin; Gram-Negative Bacteria; Humans; Infusions, Intravenous; Kidney; Osteomyelitis; Pseudomonas aeruginosa; Pseudomonas Infections; Pyelonephritis; Retrospective Studies; Urinary Tract Infections

Topics: Ampicillin; Animals; Colistin; Diuresis; Escherichia coli; Escherichia coli Infections; Female; Furosemide; Kidney; Pyelonephritis; Rats; Water-Electrolyte Balance

Topics: Adolescent; Adult; Aged; Cardiac Output; Cephalothin; Child; Child, Preschool; Colistin; Cross Infection; Female; Hemorrhage; Humans; Immunosuppression Therapy; Kanamycin; Lung; Male; Middle Aged; Neoplasms; Oxygen Consumption; Pancreatitis; Pyelonephritis; Retrospective Studies; Sepsis; Shock, Septic; Thromboembolism

Topics: Adult; Aged; Ampicillin; Anti-Bacterial Agents; Chloramphenicol; Chronic Disease; Colistin; Depression, Chemical; Drug Synergism; Erythromycin; Escherichia coli Infections; Female; Follow-Up Studies; Humans; Kanamycin; Klebsiella Infections; Male; Middle Aged; Nitrofurantoin; Oleandomycin; Oxacillin; Penicillins; Polymyxins; Proteus Infections; Pyelonephritis; Staphylococcal Infections; Stimulation, Chemical; Streptococcal Infections; Streptomycin; Sulfonamides; Tetracycline

The effect of early bilateral pyelonephritis on urinary concentrating ability was studied in rats injected intravenously with enterococci or Staphylococcus aureus and in rats inoculated with Escherichia coli into the medullae of both kidneys. The mean maximum urinary osmolality of normal rats was 2352 mOsm/kg of water. Inoculation of E. coli caused reversible pyelonephritis with sterilization of the kidneys within 12 wk. By 1 day after injection the mean maximum urinary osmolality had decreased to about 1100 mOsm. remained at this level for 3 wk, and then rose to normal by 12 wk. After injection of enterococci and staphylococci, the mean maximum urine osmolality decreased over 3-4 days to about 1000 and 800 mOsm respectively. In the enterococcal infection (which is chronic) the maximum urine osmolality remained about 1200 mOsm for at least 12 wk whereas in the staphylococcal infection (which is reversible) the osmolality gradually rose. Antimicrobial therapy of E. coli renal infection with colistimethate sodium and S. aureus infection with ampicillin rapidly reduced bacterial titers in the kidneys with an associated rise in maximum urinary osmolality. Therapy of enterococcal renal infection with ampicillin produced less impressive decreases in bacterial titers in the kidneys and little or no improvement in urinary concentrating ability. With antimicrobial therapy or with the self-limited infections, the rate of increase in concentrating ability was directly correlated with the rate of decrease of bacterial titers. However, there was poor correlation between histological findings in the kidneys and urinary concentrating ability. These studies demonstrate that early experimental pyelonephritis is associated with a concentrating defect that can be rapidly reversed and therefore is not related to permanent renal damage.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Colistin; Creatinine; Escherichia coli Infections; Kidney; Kidney Concentrating Ability; Male; Osmolar Concentration; Pyelonephritis; Rats; Staphylococcal Infections; Streptococcal Infections; Vasopressins

Topics: Ampicillin; Anti-Bacterial Agents; Bacteria; Bacteriuria; Cephalothin; Chloramphenicol; Colistin; Enterococcus faecalis; Escherichia coli; Gentamicins; Humans; Kanamycin; Nalidixic Acid; Nitrofurantoin; Penicillin Resistance; Proteus; Pseudomonas aeruginosa; Pyelonephritis; Staphylococcus; Streptococcus; Tetracycline; Urologic Diseases

Topics: Adult; Colistin; Humans; Male; Medication Errors; Poisoning; Pyelonephritis

Topics: Animals; Anti-Infective Agents; Cephalosporins; Colistin; Cystitis; Disease Models, Animal; Gentamicins; Nalidixic Acid; Pyelonephritis; Rats; Sulfadiazine; Urinary Tract Infections

Topics: Acute Kidney Injury; Adolescent; Adult; Age Factors; Aged; Apnea; Body Weight; Colistin; Drug Hypersensitivity; Female; Follow-Up Studies; Humans; Kidney Diseases; Kidney Function Tests; Male; Middle Aged; Nausea; Nervous System Diseases; Paresthesia; Pneumonia; Prospective Studies; Pyelonephritis; Respiratory Insufficiency; Sepsis; Sex Factors; Statistics as Topic; Time Factors; Vomiting

Topics: Albuminuria; Cholangitis; Chronic Disease; Colistin; Hematuria; Humans; Pyelonephritis; Urinary Tract Infections

Topics: Anti-Infective Agents, Urinary; Cephaloridine; Colistin; Gentamicins; Glomerulonephritis; Humans; Nalidixic Acid; Nitrofurantoin; Pyelonephritis; Sulfadiazine; Urinary Tract Infections

Topics: Animals; Anti-Bacterial Agents; Bacteriuria; Cephaloridine; Cephalothin; Colistin; Escherichia coli Infections; Female; Gentamicins; Kidney; Models, Biological; Naphthacenes; Proteus Infections; Pyelonephritis; Rats

Topics: Animals; Anti-Bacterial Agents; Bacteriuria; Cephaloridine; Cephalothin; Colistin; Female; Gentamicins; Pyelonephritis; Rats; Tetracycline

Topics: Animals; Colistin; Mice; Pseudomonas aeruginosa; Pseudomonas Infections; Pyelonephritis; Sulfates; Sulfonic Acids

Topics: Acute Kidney Injury; Adult; Ampicillin; Cephalothin; Chloramphenicol; Chronic Disease; Colistin; Humans; Male; Pyelonephritis; Urinary Tract Infections

Topics: Ampicillin; Anti-Bacterial Agents; Child; Chloramphenicol; Colistin; Humans; Kanamycin; Methenamine; Nitrofurantoin; Pyelonephritis; Streptomycin; Tetracycline

Topics: Calcium; Colistin; Electromyography; Humans; Hypocalcemia; Kanamycin; Male; Middle Aged; Myasthenia Gravis; Neostigmine; Neuromuscular Nondepolarizing Agents; Paraplegia; Pyelonephritis; Respiratory Insufficiency; Synaptic Transmission

Topics: Bacteriuria; Colistin; Cystitis; Escherichia coli Infections; Humans; Pseudomonas Infections; Pyelonephritis; Sulfonic Acids; Urethritis

Topics: Anti-Bacterial Agents; Chloramphenicol; Colistin; Drug Resistance; Drug Resistance, Microbial; Drug Therapy; Enterobacter; Escherichia coli Infections; Humans; Klebsiella; Nalidixic Acid; Nitrofurantoin; Proteus Infections; Pseudomonas Infections; Pyelonephritis; Statistics as Topic; Sulfonamides; Tetracycline

Topics: Adolescent; Anti-Bacterial Agents; Colistin; Drug Therapy; Geriatrics; Glomerulonephritis; Humans; Kidney Failure, Chronic; Kidney Function Tests; Pyelonephritis; Toxicology; Urinary Tract Infections

Topics: Aged; Apnea; Colistin; Female; Humans; Polymyxins; Pyelonephritis

Topics: Ampicillin; Anti-Infective Agents, Urinary; Chloramphenicol; Chronic Disease; Colistin; Humans; Nalidixic Acid; Nitrofurantoin; Pyelonephritis; Sulfonamides; Tetracycline

Topics: Colistin; Diagnosis, Differential; Enterobacter; Escherichia coli Infections; Glomerulonephritis; Kanamycin; Prognosis; Proteus Infections; Pseudomonas Infections; Pyelonephritis; Staphylococcal Infections

Topics: Administration, Intravenous; Blood Chemical Analysis; Colistin; Creatine; Creatinine; Humans; Injections, Intramuscular; Injections, Intravenous; Kidney Function Tests; Nitrogen; Pharmacology; Pneumonia; Probenecid; Pseudomonas Infections; Pyelonephritis; Sodium; Urea

Topics: Bacteriuria; Colistin; Drug Resistance; Drug Resistance, Microbial; Drug Therapy; Humans; Neomycin; Pyelonephritis

Topics: Colistin; Fluid Therapy; Humans; Kidney; Kidneys, Artificial; Pyelonephritis; Renal Dialysis; Sepsis; Serratia marcescens; Streptomycin

Topics: Colistin; Humans; Kidney Function Tests; Male; Pharmacology; Pseudomonas Infections; Pyelonephritis; Radioisotopes; Radionuclide Imaging; Staphylococcal Infections; Urography; Vasopressins

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Chloramphenicol; Colistin; Humans; Neomycin; Nitrofurantoin; Penicillins; Pseudomonas Infections; Pyelonephritis; Streptomycin; Sulfamethizole; Sulfathiazoles; Tetracycline

Topics: Chronic Disease; Colistin; Humans; Pyelonephritis