{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:08:31Z","timestamp":1788793711588,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Colistin is a last-resort agent against multidrug-resistant Gram-negative infections and is administered predominantly to complex, comorbid inpatients in whom mortality is high. We aimed to identify independent baseline predictors of in-hospital mortality in colistin-treated patients and to characterize temporal changes in mortality over 15 years. Methods: We conducted a retrospective cohort study of 1225 consecutive patients receiving systemic colistin between November 2009 and November 2024 at Parhon Hospital, a tertiary urology\u2013nephrology center in Ia\u0219i, Romania; independent predictors of death were identified using multivariable logistic regression restricted to variables fixed at the time of colistin initiation, reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Patients were predominantly male (60.2%), with a mean age of 65.1 \u00b1 14.4 years; 85.6% were admitted to urology or nephrology. In-hospital mortality was 27.6%. Mortality was independently associated with acute kidney injury (aOR 3.72, 95% CI 2.76\u20135.01), sepsis (aOR 2.79, 95% CI 2.11\u20133.70), emergency admission (aOR 1.91, 95% CI 1.40\u20132.61), Charlson comorbidity index (aOR 1.13 per point, 95% CI 1.05\u20131.22), and older age (aOR 1.03 per year, 95% CI 1.02\u20131.04); sex was not associated. Crude mortality increased across the study period (odds ratio 1.16 per year, 95% CI 1.13\u20131.20) and remained elevated after adjustment for case-mix (adjusted odds ratio 1.13 per year, 95% CI 1.09\u20131.17). Conclusions: Acute kidney injury, sepsis, emergency admission, comorbidity burden, and age were independently associated with in-hospital death. Mortality rose progressively over 15 years, only partly explained by an increasingly severe case-mix, supporting early risk stratification of colistin recipients.<\/jats:p>","DOI":"10.3390\/antibiotics15090866","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:25:56Z","timestamp":1788542756000},"page":"866","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of In-Hospital Mortality Among Hospitalized Colistin-Treated Patients at a Tertiary Urology\u2013Nephrology Referral Center"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2065-2926","authenticated-orcid":false,"given":"Viorel Dragos","family":"Radu","sequence":"first","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6304-9950","authenticated-orcid":false,"given":"Ana-Maria Raluca","family":"Pauna","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"software","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5335-7909","authenticated-orcid":false,"given":"Rodica","family":"Radu","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7983-3811","authenticated-orcid":false,"given":"Liliana","family":"Mititelu-Tartau","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9865-5114","authenticated-orcid":false,"given":"Alin Mihai","family":"Vasilescu","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5860-3696","authenticated-orcid":false,"given":"Theodor Florin","family":"Pantilimonescu","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6641-5135","authenticated-orcid":false,"given":"Adriana","family":"Grigora\u0219","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Florea","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5292-7971","authenticated-orcid":false,"given":"Marius Constantin","family":"Moraru","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Liliana","family":"Chelaru","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Liviu Ciprian","family":"Gavril","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Roxana Florentina","family":"Gavril","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, Universitatii No. 16 Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0693-5478","authenticated-orcid":false,"given":"Beatrice Rozalina","family":"Buca","sequence":"additional","affiliation":[{"name":"\u201cGrigore T. 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