{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T18:31:16Z","timestamp":1776796276943,"version":"3.51.2"},"reference-count":38,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2005,8,1]],"date-time":"2005-08-01T00:00:00Z","timestamp":1122854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2005,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Colistin,\nan antibiotic almost abandoned for intravenous administration for many\nyears due to its reported toxicity, has been recently reintroduced in\nclinical practice due to the emergence of multidrug-resistant\ngram-negative bacteria and the lack of development of new antibiotics\nto combat them. To assess the safety and effectiveness of intravenous\ncolistin, in combination with other antimicrobial agents, in the\ntreatment of serious infections in patients without cystic fibrosis, a\nretrospective cohort study in a 450-bed tertiary-care hospital in\nAthens, Greece, was performed. Patients who were hospitalized from 1\nOctober 2000 to 31 January 2004 and received intravenous colistin for\nmore than 72 h were further analyzed. The primary outcome\nmeasure was the in-hospital mortality; secondary end points were the\nclinical outcome of the infections and the occurrence of colistin\ntoxicity. Fifty patients received intravenous colistin with a median\n(mean) daily dose of 3 (4.5) million IU for 16.5 (21.3) days for the\nmanagement of 54 episodes of infections due to multidrug-resistant\ngram-negative bacteria. The predominant infections were pneumonia\n(33.3%), bacteremia (27.8%), urinary tract infection (11.1%), and\nintra-abdominal infection (11.1%). The responsible pathogens were\n            <jats:italic>Acinetobacter baumannii<\/jats:italic>\n            (51.9%),\n            <jats:italic>Pseudomonas\naeruginosa<\/jats:italic>\n            (42.6%), and\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            (3.7%)\nstrains (no pathogen was isolated from one case). In-hospital mortality\nwas 24% (12\/50 patients). Clinical response (cure or improvement) of\nthe infection was observed in 66.7% of episodes (36\/54). In the studied\ngroup, serum creatinine levels were decreased, at the end of colistin\ntreatment, by an average of 0.2 \u00b1 1.3 mg\/dl compared to\nbaseline levels. Deterioration of renal function during colistin\ntherapy was observed in 4\/50 patients (8%). Coadministration of other\nantimicrobial agents with spectrum against gram-negative microorganisms\nand the absence of a control group constitute the major limitations of\nthis study. The use of intravenous colistin for the treatment of\ninfections due to multidrug-resistant gram-negative bacteria appears to\nbe safe and\neffective.\n          <\/jats:p>","DOI":"10.1128\/aac.49.8.3136-3146.2005","type":"journal-article","created":{"date-parts":[[2005,7,27]],"date-time":"2005-07-27T10:52:45Z","timestamp":1122461565000},"page":"3136-3146","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":148,"title":["Combination Therapy with Intravenous Colistin for Management of Infections Due to Multidrug-Resistant Gram-Negative Bacteria in Patients without Cystic Fibrosis"],"prefix":"10.1128","volume":"49","author":[{"given":"Sofia K.","family":"Kasiakou","sequence":"first","affiliation":[{"name":"Alfa Institute of Biomedical Sciences, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argyris","family":"Michalopoulos","sequence":"additional","affiliation":[{"name":"Alfa Institute of Biomedical Sciences, Athens, Greece"},{"name":"Intensive Care Unit, \u201cHenry Dunant\u201d Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elpidoforos S.","family":"Soteriades","sequence":"additional","affiliation":[{"name":"Alfa Institute of Biomedical Sciences, Athens, Greece"},{"name":"Harvard School of Public Health, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Samonis","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Crete, School of Medicine, Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George J.","family":"Sermaides","sequence":"additional","affiliation":[{"name":"Alfa HealthCare, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew E.","family":"Falagas","sequence":"additional","affiliation":[{"name":"Alfa Institute of Biomedical Sciences, Athens, Greece"},{"name":"Department of Medicine, \u201cHenry Dunant\u201d Hospital, Athens, Greece"},{"name":"Tufts University School of Medicine, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/106002809102501101"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","first-page":"923","DOI":"10.5694\/j.1326-5377.1970.tb63262.x","volume":"2","year":"1970","unstructured":"Brown, J. M., D. C. Dorman, and L. P. Roy. 1970 . Acute renal failure due to overdosage of colistin.Med. J. Aust.2:923-924.","journal-title":"Med. J. Aust."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.10.1127"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.52.11.987"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.19370"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/0895-4356(92)90001-4","volume":"45","year":"1992","unstructured":"Damiano, A. M., M. Bergner, E. A. Draper, W. A. Knaus, and D. P. Wagner. 1992. Reliability of a measure of severity of illness: acute physiology of chronic health evaluation\u2014II. J. Clin. Epidemiol.45:93-101.","journal-title":"J. Clin. 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Williams & Wilkins, Baltimore, Md.","journal-title":"Hospital epidemiology and infection control"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(01)00258-9"},{"key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/S0732-8893(02)00443-1","volume":"44","year":"2002","unstructured":"Giamarellos-Bourboulis, E. J., L. Karnesis, and H. Giamarellou. 2002 . Synergy of colistin with rifampin and trimethoprim\/sulfamethoxazole on multidrug-resistant Stenotrophomonas maltophilia. Diagn. Microbiol. Infect. Dis.44:259-263.","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"e_1_3_2_15_2","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1179\/joc.2003.15.3.235","volume":"15","year":"2003","unstructured":"Giamarellos-Bourboulis, E. J., H. Sambatakou, I. Galani, and H. Giamarellou. 2003 . In vitro interaction of colistin and rifampin on multidrug-resistant Pseudomonas aeruginosa. J. Chemother.15:235-238.","journal-title":"J. Chemother."},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.3.905-909.2003"},{"key":"e_1_3_2_17_2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1056\/NEJM196409172711225","volume":"271","year":"1964","unstructured":"Holmes, K. K. 1964. Toxicity of colistin and polymyxin B. N. Engl. J. Med.271:633-634.","journal-title":"N. Engl. J. Med."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0805.020014"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1086\/377200"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-72-6-857"},{"key":"e_1_3_2_22_2","first-page":"457","volume":"3","year":"1950","unstructured":"Koyama, Y., A. Kurosasa, A. Tsuchiya, and K. Takakuta. 1950. A new antibiotic \u201ccolistin\u201d produced by spore-forming soil bacteria. J. 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