TABLE 2.

Patient characteristics based on the development of nephrotoxicity during intravenous colistin therapy (n = 30)

CharacteristicaResult for patient typeP value
Nephrotoxic (n = 10)Nonnephrotoxic (n = 20)
Demographics
    Age in years (mean ± SD)57.5 ± 15.543.3 ± 16.50.033
    APACHE II score13 (7-18)7 (3-15)0.122
    Male (%)60651.000
    ICU stay during colistin administration (%)50250.231
Colistin dosing
    SCR at beginning, mg/dl1.0 (0.6-1.2)0.8 (0.5-0.9)0.298
    SCR at end, mg/dl2.5 (2.1-4.0)0.7 (0.5-0.9)<0.001
    CrCl at beginning, ml/min86 (60-144)122 (77-144)0.301
    Treatment duration, days7 (5-16)9 (5-12)0.947
    Every-12-h dosing frequencyb (%)90650.210
    Dose per ABW, mg/kg/day4.2 (3.4-5.0)4.0 (2.7-4.6)0.301
    Dose per IBW, mg/kg/day5.5 (4.6-7.7)4.4 (3.1-5.3)0.011
    Cumulative i.v. dose, mg1,838 (1,519-4,613)1,823 (975-3,184)0.455
    Cumulative i.v. + aerosolized dose, mg1,838 (1,519-6,263)1,823 (975-3,430)0.455
    Excessive daily dosing (all) (%)80300.019
    Excessive daily dosing (because ABW used in obese patient) (%)70150.005
Alternative explanations for nephrotoxicityc
    i.v. contrast use (%)20350.675
    Concomitant vancomycin (%)50300.425
    Concomitant aminoglycosides (%)30400.702
    Concomitant ACE/ARBs (%)40150.181
    Concomitant diuretic use (%)80200.004
    Concomitant vasopressors (%)4000.008
  • a All data represent median results (25th to 75th percentile interquartile range [IQR]) unless otherwise stated. Abbreviations: APACHE, Acute Physiology and Chronic Health Evaluation; ICU, intensive care unit; SCR, serum creatinine; CrCl, creatinine clearance as calculated by Cockcroft and Gault (1); ABW, actual body weight; IBW, ideal body weight; ACE, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blockers; SD, standard deviation.

  • b Every-8-h and every-6-h dosing frequencies were administered in six patients and one patient, respectively. No patients received an every-24-h dosing regimen.

  • c Nonsteroidal antiinflammatory drugs, cyclooxygenase-2 inhibitors, and amphotericin B were not given in this cohort.