Changes in Renal Function by Nebulized Colistimethate Treatment

ABSTRACT

BACKGROUND: Nebulized colistimethate is increasingly used, because there are problems such as renal dysfunction and low distribution within the lungs when colistimethate is administered intravenously. This study was designed to compare and analyze the changes in renal function by of nebulized colistimethate treatment for its safe administration. METHODS: This study retrospectively reviewed the electronic medical records of adult patients above 19 years old, receiving only the nebulized colistimethate at least 4 days in Yonsei university health system from Nov 2014 to Aug 2015. Acute kidney injury (AKI) was determined by using the RIFLE criteria (Risk, Injury, Failure, Loss and End-stage renal disease) according to serum creatinine (SCr) levels before and after use of nebulized colistimethate. RESULTS: 48 patients were included our study and their SCr increased significantly after nebulized colistimethate treatment (SCr₀ vs. SCr₁; 0.85±0.80 vs. 1.00±0.82 mg/dL, n=48, p0.05). The study has a significance in that it reviewed the safety of nebulized colistimethate only treatment to national patients, analyzing its nephrotoxicity. It has confirmed that nebulized colistimethate is a safer method than intravenous injection, and requires to establish a guideline for the use of nebulized colistimethate in further studies with broader patient groups. (a) SCr Male 0.68-1.19 mg/dL, Female 0.49-0.91 mg/dL