{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:26:41Z","timestamp":1790022401804,"version":"4.0.1"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Despite colistin\u2019s longstanding reported association with nephrotoxicity, the attributable risk and timing of toxicity onset are still unknown. Whether substantial toxicity occurs during the initial 72 hours of exposure has important implications for early treatment decisions. The objective of this study was to compare colistin-exposed patients with a matched control group given other broad spectrum antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study in patients treated for multidrug-resistant\n                      <jats:italic toggle=\"yes\">Pseudomonas<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Klebsiella<\/jats:italic>\n                      , or\n                      <jats:italic toggle=\"yes\">Acinetobacter<\/jats:italic>\n                      spp. Colistin-exposed patients were matched to unexposed controls using propensity scores. AKI was defined according to the Kidney Disease Improving Global Outcomes creatinine criteria. Incidence rate ratios and risk differences of AKI in the matched cohort were estimated with the generalized estimating equation Poisson regression model. Risk factors for AKI were tested for effect modification in the matched cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 150 propensity-matched pairs with similar types of infection, similar delays to effective treatment, and similar baseline characteristics. Incidence of AKI was 77 of 150 (51%) in the colistin group versus 33 of 150 (22%) in matched controls (risk difference, 29%; 95% confidence interval, 19 to 39), corresponding to a number needed to harm of 3.5. Early toxicity was apparent, because AKI risk was higher in colistin-exposed patients at 72 hours of exposure (incidence rate ratio, 1.9; 95% confidence interval, 1.1 to 3.5). In both groups, hospital mortality in patients who experienced AKI was lower if kidney function returned to baseline during hospitalization. The effect of colistin exposure on AKI risk varied inversely according to baseline hemoglobin concentration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Colistin is associated with substantial excess AKI that is apparent within the first 72 hours of treatment. Colistin\u2019s toxicity varied according to baseline hemoglobin concentration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Podcast<\/jats:title>\n                    <jats:p>This article contains a podcast at https:\/\/www.asn-online.org\/media\/podcast\/CJASN\/2018_03_15_CJASNPodcast_18_4_M.mp3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.06980717","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T10:15:19Z","timestamp":1521108919000},"page":"542-550","source":"Crossref","is-referenced-by-count":46,"title":["Attributable Risk and Time Course of Colistin-Associated Acute Kidney Injury"],"prefix":"10.2215","volume":"13","author":[{"given":"Todd A.","family":"Miano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebbing","family":"Lautenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2633-2412","authenticated-orcid":false,"given":"F. Perry","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wensheng","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuliya","family":"Borovskiy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Hennessy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,3,15]]},"reference":[{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1093\/cid\/cit152","article-title":"10 x \u201920 Progress--development of new drugs active against gram-negative bacilli: An update from the Infectious Diseases Society of America.","volume":"56","author":"Boucher","year":"2013","journal-title":"Clin Infect Dis"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1097\/CCM.0000000000000125","article-title":"Risk factors and outcome analysis of acinetobacter baumannii complex bacteremia in critical patients.","volume":"42","author":"Lee","year":"2014","journal-title":"Crit Care Med"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1128\/AAC.49.4.1306-1311.2005","article-title":"Pseudomonas aeruginosa bloodstream infection: Importance of appropriate initial antimicrobial treatment.","volume":"49","author":"Micek","year":"2005","journal-title":"Antimicrob Agents Chemother"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1093\/cid\/cis588","article-title":"Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: Importance of combination therapy.","volume":"55","author":"Tumbarello","year":"2012","journal-title":"Clin Infect Dis"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/01.shk.0000246899.73315.cb","article-title":"When to include polymyxins in the empirical antibiotic regimen in critically ill patients with fever? 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