Accès libre

The Susceptibility of MDR-K. Pneumoniae to Polymyxin B Plus its Nebulised Form Versus Polymyxin B Alone in Critically Ill South Asian Patients

Md. Jahidul Hasan
Md. Jahidul Hasan
, 
Raihan Rabbani
Raihan Rabbani
, 
Ahmad Mursel Anam
Ahmad Mursel Anam
, 
Ario Santini
Ario Santini
 et 
Shihan Mahmud Redwanul Huq
Shihan Mahmud Redwanul Huq
   | 29 janv. 2021
The Journal of Critical Care Medicine's Cover Image
À propos de cet article
Article précédent
Article suivant
Citez
Article Category: Research Article
Publié en ligne: 29 janv. 2021
Pages: 28 - 36
Reçu: 15 juil. 2020
Accepté: 23 nov. 2020
DOI: https://doi.org/10.2478/jccm-2020-0044
Mots clés
© 2021 Md. Jahidul Hasan, Raihan Rabbani, Ahmad Mursel Anam, Ario Santini, Shihan Mahmud Redwanul Huq, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Fig. 1

Kaplan-Meier 30-day survival curve for intravenous polymyxin B with nebulization (green line) and only intravenous polymyxin B (blue line). Analysis run using Group (polymyxin B intravenously with nebulization vs intravenous polymyxin B only) as factor; death as event and time to death as time variable.
Kaplan-Meier 30-day survival curve for intravenous polymyxin B with nebulization (green line) and only intravenous polymyxin B (blue line). Analysis run using Group (polymyxin B intravenously with nebulization vs intravenous polymyxin B only) as factor; death as event and time to death as time variable.

Fig. 2

Adverse events associated with polymyxin B in both the groups (polymyxin B intravenously with nebulization vs intravenous polymyxin B alone)
Adverse events associated with polymyxin B in both the groups (polymyxin B intravenously with nebulization vs intravenous polymyxin B alone)

Clinical outcomes of patients with intravenous polymyxin B with or without the nebulised form.

Parameter Odds ratio (95% confidence interval) p-value
Microbial eradication 0.19 (0.06-0.58) 0.003
Secondary bacterial infection 0.17 (0.05-0.59) 0.005
30-day mortality 0.45 (0.14-1.43) 0.178

Demographic and baseline characteristics of the patients

Variables
Characterisitcs
p-value
PIVNL group (n=64) PIV group (n=57)
Age (year)
Mean 64.1±16.1 63.9±14.3
Range (min-max) 20-86 20-87 0.950
Gender
Male 37 33
Female 27 24 0.993
Comorbidities
Hypertension, n (%) 31 (48.4) 26 (45.6) 0.756
Diabetes mellitus, n (%) 30 (46.8) 27 (47.3) 0.957
Chronic lung diseases, n (%) 16 (25) 13 (22.8) 0.778
APACHE II Score (0-30)
Mean 18±4.8 18.3±5.5
Range (min-max) 10–30 8–30 0.727
C-reactive protein (<10.0 mg/mL)
Mean 161.7(112.8) 139.2±105.3
Range (min-max) 11.7–393.6 10.3–390.3 0.260
Procalcitonin (<0.1 ng/mL)
Mean 7.5(17.3) 7.4±14.4
Range (min-max) 0.2–114 0.1–68.5 0.976
White blood cell (4-11 K/μL)
Mean 19.2(7.3) 18.9±7.3
Range (min-max) 9.7–46.1 11.1–47.6 0.823
Serum creatinine (0.8-1.4 mg/dL)
Mean 1.6(0.5) 1.5±0.5
Range (min-max) 0.6–2.3 0.6–2.5 0.905

Extubation, reintubation and hospitalisation time of the patients

Group Time to extubation, n (%) p-value ICU length-of-stay, n (%) p-value 21-day reintubation, n (%) P value
≥4 weeks: nil ≥4 weeks: 4 (6.25)
PIVNL ≥3 weeks: 1 (1.5) ≥3 weeks: 7 (10.9)
(n=64) ≥2 weeks: 19 (29.7) ≥2 weeks: 38 (59.4) 8 (12.5)
≥1 week: 40 (62.5) ≥1 week: 14 (21.9)
<1 week: 4 (6.3) <1 week: 1 (1.6)
≥4 weeks: 13 (22.8) 0.001** ≥1 weeks: 36 (63.2) 0.002** 0.089**
≥3 weeks: 15 (26.3) ≥3 weeks: 14 (24.5)
PIV ≥2 weeks: 25 (43.9) ≥2 weeks: 4 (7.0) 17 (29.8)
(n=57) ≥1 week: 4 (7.0) ≥1 week: nil
<1 week: nil <1 week: 3 (5.3)
eISSN:
2393-1817
Langue:
Anglais
Périodicité:
4 fois par an
Sujets de la revue:
Médecine, Médecine clinique, Médecine interne, autres, Chirurgie, Anesthésiologie, Médecine d'urgence et médecine intensive
RSS Feed de la revue