Colistin plasma concentrations are not associated with better clinical outcomes in patients with pneumonia caused by extremely drug-resistant Pseudomonas aeruginosa

Sorli Redó, M. Luisa; Luque Pardos, Sònia; Li, Jian; Benítez-Cano, Adela; Fernández, Xenia; Prim, Núria; Vega, Victoria; Gómez Junyent, Joan; López Montesinos, Inmaculada; Gómez-Zorrilla, Silvia; Montero, Maria Milagro; Grau Cerrato, Santiago; Horcajada Gallego, Juan Pablo

doi:http://dx.doi.org/10.1128/spectrum.02967-23

Colistin plasma concentrations are not associated with better clinical outcomes in patients with pneumonia caused by extremely drug-resistant Pseudomonas aeruginosa

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Sorlí L, Luque S, Li J, Benítez-Cano A, Fernández X, Prim N, et al. Colistin plasma concentrations are not associated with better clinical outcomes in patients with pneumonia caused by extremely drug-resistant Pseudomonas aeruginosa. Microbiol Spectr. 2023 Dec 12;11(6):e0296723. DOI: 10.1128/spectrum.02967-23

Abstract

In some cases, colistin is the only treatment option for infections caused by the very drug-resistant Pseudomonas aeruginosa. However, in the past decade, there have been questions concerning its pharmacokinetics and concentration at the site of infection. In this scenario, its use in a difficult-to-treat infection like pneumonia is currently debatable. This is a clinical pharmacokinetic study of colistin in patients with multidrug-resistant P. aeruginosa pneumonia. Our findings demonstrate that colistin exposure is associated with worse clinical outcomes rather than better clinical outcomes, implying that other therapeutic options should be explored in this clinical setting.