Background Colistin (polymyxin E) is a mixture of cyclic polypeptides colistin A and B and it remains one of the last-resort antibiotics for multidrug resistant species of Pseudomonas and Acinetobacter. The increased use of Colistin was noticed at the end of 2011.
Purpose To analyse the use of Colistin due to increased bacterial resistance and difficulties in supply, as no licence has been issued for marketing authorization of this medicine in Serbia.
Materials and Methods A retrospective descriptive study of patients who started Colistin treatment from January to September 2012. We reviewed those forms that recorded: patient demographic data, posology, duration, kind of treatment and type of infection. All data were collected in an Excel database.
Results In this period, 86 patients were prescribed Colistin (55% men). In 74% cases the posology was 1M IU/8h, and in 26% was 2M IU/8h; mean duration of treatment was 18.07 days, but in 38% patients we did not get data about duration of treatment. Colistin was used in the following departments: ICU (74%), Surgery (7%) Internal Medicine (5%), and other several wards (14%). Colistin treatment was started empirically in 16% of patients. Microbiological diagnosis (Pseudomonas sp. that were aminoglycosides and carbapenems-resistant, and multi-drug resistant Acinetobacter baumannii) was the reason for Colistin treatment in 84% of patients.
Conclusions Due to the increased number of patients in a seriously difficult, life-threatening conditions caused by severe nosocomial infections it is necessary to establish strict control over Colistin prescribing (an antibiogram based on blood culture or cerebrospinal fluid, council of infectiology experts etc.). The possibility of getting it registered in Serbia and included on the list of reimbursed drugs should be investigated. It is also necessary to monitor carefully, and to improve our active communication with, the main wards in order to promote the rational use of antibiotics.
No conflict of interest.
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