Sorli Redó, M. LuisaLuque Pardos, SòniaSegura, ConcepciónCampillo Ambrós, NúriaMontero, Maria MilagroEsteve, ErikaHerrera, SabinaBenito, NatividadÁlvarez Lerma, FranciscoGrau Cerrato, SantiagoHorcajada Gallego, Juan Pablo2017-07-132017-07-132017Sorli Redó ML, Luque Pardos S, Segura C, Campillo Ambrós N, Montero MM, Esteve E et al. Impact of colistin plasma levels on the clinical outcome of patients with infections caused by extremely drug-resistant Pseudomonas aeruginosa. BMC Infectious Diseases. 2017;17(1):11. DOI: 10.1186/s12879-016-2117-71471-2334http://hdl.handle.net/10230/32533Background: Colistin has a narrow therapeutic window with nephrotoxicity being the major dose-limiting adverse effect. Currently, the optimal doses and therapeutic plasma levels are unknown. Methods: Prospective observational cohort study, including patients infected by colistin-susceptible P. aeruginosa treated with intravenous colistimethate sodium (CMS). Clinical data and colistin plasma levels at steady-state (Css) were recorded. The primary and secondary end points were clinical cure and 30-day all-cause mortality. Results: Ninety-one patients were included. Clinical cure was observed in 72 (79%) patients. The mean (SD) Css was 1.49 (1.4) mg/L and 2.42 (1.5) mg/L (p = 0.01) in patients who achieved clinical cure and those who not, respectively. Independent risk factors for clinical failure were male sex (OR 5.88; 95% CI 1.09–31.63), APACHE II score (OR 1.15; 95% CI 1.03–1.27) and nephrotoxicity at the EOT (OR 9.13; 95% CI 95% 2.06–40.5). The 30-day mortality rate was 30.8%. Risk factors for 30-day mortality included the APACHE II score (OR 1.98; 95% CI 1–1.20), the McCabe score (OR 2.49; 95% CI 1.14–5.43) and the presence of nephrotoxicity at the end of treatment (EOT) (OR 3.8; 95% CI 1.26–11.47). Conclusion: In this series of patients with infections caused by XDR P. aeruginosa infections, Css is not observed to be related to clinical outcome.application/pdfeng© Sorlí L, Luque S, Segura C, Campillo N, Montero M, Esteve E, Herrera S, Benito N, Alvarez-LErma F, Grau S, Horcajada Gallego JP. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.info:eu-repo/semantics/articlehttp://dx.doi.org/10.1186/s12879-016-2117-7ColistinMortalityPlasma concentrationPseudomonas aeruginosaExtremely drug-resistantNephrotoxicityinfo:eu-repo/semantics/openAccess