{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T14:38:57Z","timestamp":1774276737785,"version":"3.50.1"},"reference-count":61,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Bacterial infections amongst COVID-19 patients could be associated with worsened outcomes. This study aimed to investigate the efficacy of colistin antibiotic in multidrug-resistant (MDR) Gram-negative (-ve) secondary bacterial infections among hospitalized COVID-19 patients. Materials and Methods: In this multicentered retrospective study, we analyzed data from the medical records of 116 patients diagnosed with COVID-19 infection and secondary Gram-negative MDR bacterial respiratory infections. Results: We compared those assigned to colistin versus non-colistin-based antimicrobial therapy. The two arms of the study were similar in baseline clinical features, demographics, and Gram-negative pathogens\u2019 distribution. Acinetobacter baumannii (51.7%) was the major pathogen, followed by Klebsiella pneumonia (26.7%). Patients who received colistin-based antimicrobial regimen showed a non-significant difference compared to non-colistin antimicrobial (NCA) therapy (p &gt; 0.05) in the main outcomes. Nephrotoxicity was significantly higher in the IV colistin group, compared to the control (34.1% and 15.3%, p = 0.018). There were substantial differences observed in the levels of serum creatinine and urea among the study arms (p = 0.029 and &lt;0.001, respectively). Conclusions: The combination of colistin with other antimicrobial agents showed comparable results to that of NCA regimens in hospitalized COVID-19 patients with superinfections with multidrug-resistant bacterial isolates; however, there was a notably elevated incidence of nephrotoxicity with colistin antimicrobial therapy. Further randomized controlled trials are needed to assess the therapeutic benefits and tolerability of colistin antimicrobial therapy.<\/jats:p>","DOI":"10.3390\/medicina61050884","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T11:31:49Z","timestamp":1747135909000},"page":"884","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Efficacy and Tolerability of Colistin Versus Non-Colistin Antimicrobial Regimens Among Hospitalized COVID-19 Patients with Multidrug-Resistant Bacterial Superinfection: An Observational Multicenter Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7243-3006","authenticated-orcid":false,"given":"Alzahraa M.","family":"Fahmy","sequence":"first","affiliation":[{"name":"Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5466-0552","authenticated-orcid":false,"given":"Marwa O.","family":"Elgendy","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Beni-Suef University Hospitals, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt"},{"name":"Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Beni-Suef 62511, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa Aboud","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-3472","authenticated-orcid":false,"given":"Mohamed S.","family":"Imam","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, National Cancer Institute, Cairo University, Fom El Khalig Square, Kasr Al-Aini Street, Cairo 11796, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah Nasser","family":"Alharbi","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Hafr Al Batin University, Hafr Al-Batin 31991, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2341-9207","authenticated-orcid":false,"given":"Muhammad Husayn","family":"Al-Anezi","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Hafr Al Batin University, Hafr Al-Batin 31991, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar Mana","family":"Aldhafeeri","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Hafr Al Batin University, Hafr Al-Batin 31991, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saif Mamdouh","family":"Aldhafeeri","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Hafr Al Batin University, Hafr Al-Batin 31991, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jawaher A.","family":"Ajeebi","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Jazan University, Jazan 82912, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwa","family":"Kamal","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Faculty of Pharmacy, Fayoum University, Fayoum 63514, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2990-5981","authenticated-orcid":false,"given":"Hasnaa","family":"Osama","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bazaid, A.S., Barnawi, H., Qanash, H., Alsaif, G., Aldarhami, A., Gattan, H., Alharbi, B., Alrashidi, A., Al-Soud, W.A., and Moussa, S. (2022). Bacterial coinfection and antibiotic resistance profiles among hospitalised COVID-19 patients. Microorganisms, 10.","DOI":"10.3390\/microorganisms10030495"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.61466\/ijcmr2030003","article-title":"Relation between ABO and RhD and prevalence and severity of COVID-19 disease","volume":"2","author":"Khalaf","year":"2024","journal-title":"Int. J. Clin. Med. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e14116","DOI":"10.1111\/ijcp.14116","article-title":"A study of the possible factors affecting COVID-19 spread, severity and mortality and the effect of social distancing on these factors: Machine learning forecasting model","volume":"75","author":"Zawbaa","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"AbdelHalim, M.M., El Sherbini, S.A., Ahmed, E.S.S., Gharib, H.A.A., Elgendy, M.O., Ibrahim, A.R., and Abdel Aziz, H.S. (2024). Management of Ventilator-Associated Pneumonia Caused by Pseudomonas and Acinetobacter Organisms in a Pediatric Center: A Randomized Controlled Study. Medicina, 60.","DOI":"10.3390\/medicina60122098"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Aziz, H.S.A., Ismail, D.K., Mohammed, N.S.A., Elgendy, M.O., and Bassiouny, D.M. (2024). Distribution and antifungal susceptibility profiles of Candida species isolated from candidemia patients admitted to Egyptian tertiary hospitals: A cross-sectional study. BMC Infect. Dis., 24.","DOI":"10.1186\/s12879-024-10007-w"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"108427","DOI":"10.1016\/j.clim.2020.108427","article-title":"COVID-19 pathophysiology: A review","volume":"215","author":"Yuki","year":"2020","journal-title":"Clin. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.4155\/fmc-2017-0115","article-title":"Discovery of a COX-2 selective inhibitor hit with anti-inflammatory activity and gastric ulcer protective effect","volume":"9","author":"Abdelgawad","year":"2017","journal-title":"Future Med. Chem."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"43","DOI":"10.61466\/ijcmr1020007","article-title":"COVID-19 a global crisis: Features, complications and suggested treatments","volume":"1","author":"ElKasabgy","year":"2023","journal-title":"Int. J. Clin. Med. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2986","DOI":"10.1002\/jmv.27717","article-title":"SARS-CoV-2 variants and vulnerability at the global level","volume":"94","author":"Chavda","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_10","first-page":"162","article-title":"SARS-CoV-2 variant biology: Immune escape, transmission and fitness","volume":"21","author":"Carabelli","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_11","first-page":"11","article-title":"Secondary multidrug resistant bacterial pneumonia among adult COVID-19 patients: A molecular study","volume":"4","author":"Khalifa","year":"2023","journal-title":"Microbes Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mutua, J.M., Njeru, J.M., and Musyoki, A.M. (2022). Multidrug resistant bacterial infections in severely ill COVID-19 patients admitted in a national referral and teaching hospital, Kenya. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07885-3"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2174\/1874070701812010056","article-title":"Microbial diversity of mer operon genes and their potential rules in mercury bioremediation and resistance","volume":"12","author":"Naguib","year":"2018","journal-title":"Open Biotechnol. J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Sayed, A.M., Alhadrami, H.A., El-Gendy, A.O., Shamikh, Y.I., Belbahri, L., Hassan, H.M., Abdelmohsen, U.R., and Rateb, M.E. (2020). Microbial natural products as potential inhibitors of SARS-CoV-2 main protease (Mpro). Microorganisms, 8.","DOI":"10.3390\/microorganisms8070970"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.cmi.2020.07.041","article-title":"Incidence of co-infections and superinfections in hospitalized patients with COVID-19: A retrospective cohort study","volume":"27","author":"Sanjuan","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ahmed, E., El-Gendy, A.O., Hamblin, M.R., and Mohamed, T. (2021). The effect of femtosecond laser irradiation on the growth kinetics of Staphylococcus aureus: An in vitro study. J. Photochem. Photobiol. B Biol., 221.","DOI":"10.1016\/j.jphotobiol.2021.112240"},{"key":"ref_17","first-page":"11","article-title":"Spectrum of Bacterial Pathogens in Critical COVID-19 Patients Admitted in Intensive Care Units of a Tertiary Care Hospital During the First and Second Wave of the Pandemic","volume":"70","author":"Behera","year":"2022","journal-title":"J. Assoc. Physicians India"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5564","DOI":"10.1016\/j.vaccine.2020.06.083","article-title":"Bacillus Calmette\u2013Gu\u00e9rin vaccine, antimalarial, age and gender relation to COVID-19 spread and mortality","volume":"38","author":"Saeed","year":"2020","journal-title":"Vaccine"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Wang, L., Zhou, K.-H., Chen, W., Yu, Y., and Feng, S.-F. (2019). Epidemiology and risk factors for nosocomial infection in the respiratory intensive care unit of a teaching hospital in China: A prospective surveillance during 2013 and 2015. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-3772-2"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1080\/14786419.2020.1831495","article-title":"Metabolomic profiling and antioxidant potential of three fungal endophytes derived from Artemisia annua and Medicago sativa","volume":"36","author":"Sayed","year":"2022","journal-title":"Nat. Prod. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Abdelrahman, M.A., Zaki, A., Salem, S.A., Salem, H.F., Ibrahim, A.R., Hassan, A., and Elgendy, M.O. (2023). The Impact of Cefepime and Ampicillin\/Sulbactam on Preventing Post-Cesarean Surgical Site Infections, Randomized Controlled Trail. Antibiotics, 12.","DOI":"10.3390\/antibiotics12121666"},{"key":"ref_22","first-page":"161","article-title":"Clinical screening for bacteriocinogenic Enterococcus faecalis isolated from intensive care unit inpatient in Egypt","volume":"4","author":"Essam","year":"2013","journal-title":"J. Microb. Biochem. Technol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ijid.2021.03.004","article-title":"Treatment outcome and adverse effects of colistin in adult patients with carbapenem-resistant gram-negative bacteremia from Pakistan","volume":"106","author":"Babar","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"60","DOI":"10.61466\/ijcmr2020004","article-title":"COVID-19\u2019s effects on undergraduate medical education","volume":"2","author":"Alessio","year":"2024","journal-title":"Int. J. Clin. Med. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"209","DOI":"10.61466\/ijcmr2060002","article-title":"Immediate and long-term effects of COVID-19\u2019s on the pharmaceutical industry","volume":"2","author":"Audrick","year":"2024","journal-title":"Int. J. Clin. Med. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"218","DOI":"10.30699\/ijmm.17.2.218","article-title":"Efficacy of Amikacin and Imipenem Against Multi-Drug Resistant Gram-Negative Bacteria Isolated from Wound Infections, Egypt","volume":"17","author":"Abdalla","year":"2023","journal-title":"Iran. J. Med. Microbiol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Farhan, S.M., Raafat, M., Abourehab, M.A., Abd El-Baky, R.M., Abdalla, S., El-Gendy, A.O., and Azmy, A.F. (2021). Effect of imipenem and amikacin combination against multi-drug resistant Pseudomonas aeruginosa. Antibiotics, 10.","DOI":"10.3390\/antibiotics10111429"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1093\/jac\/dkx368","article-title":"Comparative efficacy and safety of treatment options for MDR and XDR Acinetobacter baumannii infections: A systematic review and network meta-analysis","volume":"73","author":"Kengkla","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1017\/ice.2020.156","article-title":"Bacterial and fungal infections in COVID-19 patients: A matter of concern","volume":"41","author":"Zhou","year":"2020","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1093\/cid\/ciaa530","article-title":"Bacterial and fungal coinfection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing","volume":"71","author":"Rawson","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Salah, H., Sinan, I., Alsamani, O., Abdelghani, L.S., ElLithy, M.H., Bukamal, N., Jawad, H., Hussein, R.R.S., Elgendy, M.O., and Rabie, A.S.I. (2023). COVID-19 booster doses: A multi-center study reflecting healthcare providers\u2019 perceptions. Vaccines, 11.","DOI":"10.3390\/vaccines11061061"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.22207\/JPAM.14.2.22","article-title":"Molecular Characterization of Quinolone Resistant Urinary Isolates of Escherichia coli","volume":"14","author":"Haggag","year":"2020","journal-title":"J. Pure Appl. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.jmii.2019.10.009","article-title":"Performance of a multiplex PCR pneumonia panel for the identification of respiratory pathogens and the main determinants of resistance from the lower respiratory tract specimens of adult patients in intensive care units","volume":"52","author":"Lee","year":"2019","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1007\/s12602-020-09711-1","article-title":"Anti-proliferative and anti-biofilm potentials of bacteriocins produced by non-pathogenic Enterococcus sp","volume":"13","author":"Molham","year":"2021","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.ijantimicag.2014.07.004","article-title":"Colistin for the treatment of ventilator-associated pneumonia caused by multidrug-resistant Gram-negative bacteria: A systematic review and meta-analysis","volume":"44","author":"Gu","year":"2014","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.ijid.2021.06.007","article-title":"Aerosolized plus intravenous colistin vs intravenous colistin alone for the treatment of nosocomial pneumonia due to multidrug-resistant Gram-negative bacteria: A retrospective cohort study","volume":"108","author":"Almangour","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Khalil, E.M., Madney, Y.M., Hassan, M., Fahmy, A.M., Alshammari, S.O., Alshammari, Q.A., Abou-Taleb, H.A., Taha, A.A., Elgendy, M.O., and Ali, H.A. (2024). Maternal and Fetal Outcome of COVID-19 Infection among Pregnant Women. Medicina, 60.","DOI":"10.3390\/medicina60101676"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Ismael, M.S., Elgendy, M.O., Binsaleh, A.Y., Saleh, A., Abdelrahim, M.E., and Osama, H. (2024). Impulsivity and Its Association with Depression and Anxiety in the Normal Egyptian Population Post COVID-19 Pandemic. Medicina, 60.","DOI":"10.3390\/medicina60081367"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"325","DOI":"10.3346\/jkms.2011.26.3.325","article-title":"The outcomes of using colistin for treating multidrug resistant Acinetobacter species bloodstream infections","volume":"26","author":"Lim","year":"2011","journal-title":"J. Korean Med. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/0253-7613.150383","article-title":"Comparison of colistin monotherapy and non-colistin combinations in the treatment of multi-drug resistant Acinetobacter spp. bloodstream infections: A Multicenter retrospective analysis","volume":"47","author":"Balkan","year":"2015","journal-title":"Indian J. Pharmacol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Said, K.B., Alsolami, A., Moussa, S., Alfouzan, F., Bashir, A.I., Rashidi, M., Aborans, R., Taha, T.E., Almansour, H., and Alazmi, M. (2022). COVID-19 clinical profiles and fatality rates in hospitalized patients reveal case aggravation and selective co-infection by limited gram-negative bacteria. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095270"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"89","DOI":"10.21608\/ejmm.2024.340915.1389","article-title":"Prevalence and Antimicrobial Susceptibility Profile of Gram-negative and Gram-positive Bacteria in a Tertiary Hospital: A Retrospective Study","volume":"34","author":"Abbas","year":"2025","journal-title":"Egypt. J. Med. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.kint.2020.03.005","article-title":"Kidney disease is associated with in-hospital death of patients with COVID-19","volume":"97","author":"Cheng","year":"2020","journal-title":"Kidney Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1590\/2175-8239-jbn-2021-0071","article-title":"Presentation and outcomes of chronic kidney disease patients with COVID-19","volume":"44","author":"Branco","year":"2021","journal-title":"Braz. J. Nephrol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Jung, S., Chung, E.K., Jun, M.S., Son, E.S., and Rhie, S.J. (2019). Differences in colistin administration and bacterial and treatment outcomes in critically ill patients. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-44965-y"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"43","DOI":"10.26689\/jcnr.v6i3.3852","article-title":"An observational study on the management of COVID-19 patients in limited-resource hospitals","volume":"6","author":"Elgendy","year":"2022","journal-title":"J. Clin. Nurs. Res."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Yarijani, Z.M., and Najafi, H. (2021). Kidney injury in COVID-19 patients, drug development and their renal complications: Review study. Biomed. Pharmacother., 142.","DOI":"10.1016\/j.biopha.2021.111966"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Elgendy, M.O., El-Gendy, A.O., Elgendy, S.O., Abdelaty, L.N., Abdelrahim, M.E., and Abdelrahman, M.A. (2023). Perceptions, Knowledge, and Experiences of Using Face Masks among Egyptian Healthcare Workers during the COVID-19 Pandemic: A Cross-Sectional Study. Healthcare, 11.","DOI":"10.3390\/healthcare11060838"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"R174","DOI":"10.1186\/cc12853","article-title":"Risk factors for acute kidney injury in critically ill patients receiving high intravenous doses of colistin methanesulfonate and\/or other nephrotoxic antibiotics: A retrospective cohort study","volume":"17","author":"Rocco","year":"2013","journal-title":"Crit. Care"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Zhou, Y., Li, J., Wang, L., Zhu, X., Zhang, M., and Zheng, J. (2022). Acute kidney injury and drugs prescribed for COVID-19 in diabetes patients: A real-world disproportionality analysis. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.833679"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1016\/j.ekir.2020.07.035","article-title":"Acute kidney injury associated with lopinavir\/ritonavir combined therapy in patients with COVID-19","volume":"5","author":"Binois","year":"2020","journal-title":"Kidney Int. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1007\/s10156-012-0430-7","article-title":"Use of high-dose IV and aerosolized colistin for the treatment of multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia: Do we really need this treatment?","volume":"18","author":"Kalin","year":"2012","journal-title":"J. Infect. Chemother."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/s10103-020-03104-0","article-title":"The bactericidal efficacy of femtosecond laser-based therapy on the most common infectious bacterial pathogens in chronic wounds: An in vitro study","volume":"36","author":"Ahmed","year":"2021","journal-title":"Lasers Med. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/01.sa.0000433233.83668.c4","article-title":"Efficacy of high-dose nebulized colistin in ventilator-associated pneumonia caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii","volume":"57","author":"Lu","year":"2013","journal-title":"Surv. Anesthesiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1093\/jac\/dkx167","article-title":"Pharmacokinetics of nebulized colistin methanesulfonate in critically ill patients","volume":"72","author":"Boisson","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Karami, H., Derakhshani, A., Ghasemigol, M., Fereidouni, M., Miri-Moghaddam, E., Baradaran, B., Tabrizi, N.J., Najafi, S., Solimando, A.G., and Marsh, L.M. (2021). Weighted gene co-expression network analysis combined with machine learning validation to identify key modules and hub genes associated with SARS-CoV-2 infection. J. Clin. Med., 10.","DOI":"10.3390\/jcm10163567"},{"key":"ref_57","unstructured":"World Health Organization (2022). Clinical Care for Severe Acute Respiratory Infection: Toolkit: COVID-19 Adaptation, World Health Organization."},{"key":"ref_58","first-page":"1342","article-title":"The efficacy of using different antibiotics to prevent maternal surgical site infections in COVID-19-infected cases","volume":"6","author":"Zaki","year":"2023","journal-title":"Eur. Chem. Bull."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Shaban, M., Elgendy, M.O., Fahmy, A.M., Khalil, D.M., El-Gendy, A.O., Mahmoud, T.M., and Abdelrahim, M.E. (2022). The Outcomes of COVID-19 Patients with Spontaneous Intracerebral Hemorrhage Comorbidity and the Efficacy of Enoxaparin in Decreasing the Mortality Rate in Them: Single Egyptian Center Report. J. Pers. Med., 12.","DOI":"10.3390\/jpm12111822"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jinf.2014.10.004","article-title":"Resistance patterns and outcomes in intensive care unit (ICU)-acquired pneumonia. Validation of European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC) classification of multidrug resistant organisms","volume":"70","author":"Torres","year":"2015","journal-title":"J. Infect."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/cc11454","article-title":"Diagnosis, evaluation, and management of acute kidney injury: A KDIGO summary (Part 1)","volume":"17","author":"Kellum","year":"2013","journal-title":"Crit. Care"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/884\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:31:40Z","timestamp":1760031100000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":61,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["medicina61050884"],"URL":"https:\/\/doi.org\/10.3390\/medicina61050884","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,13]]}}}