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Colistin Resistance...
Colistin Resistance Development Following Colistin-Meropenem Combination Therapy Versus Colistin Monotherapy in Patients With Infections Caused by Carbapenem-Resistant Organisms
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Dickstein, Yaakov (author)
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Lellouche, Jonathan (author)
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Schwartz, David (author)
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Nutman, Amir (author)
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Rakovitsky, Nadya (author)
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Dishon Benattar, Yael (author)
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Altunin, Sergey (author)
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Bernardo, Mariano (author)
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Iossa, Domenico (author)
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Durante-Mangoni, Emanuele (author)
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Antoniadou, Anastasia (author)
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Skiada, Anna (author)
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Deliolanis, Ioannis (author)
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Daikos, George L (author)
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Daitch, Vered (author)
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Yahav, Dafna (author)
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Leibovici, Leonard (author)
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- Rognås, Viktor (author)
- Uppsala universitet,Institutionen för farmaceutisk biovetenskap,Pharmacometrics
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- Friberg, Lena E. (author)
- Uppsala universitet,Institutionen för farmaceutisk biovetenskap,Pharmacometrics
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Mouton, Johan W (author)
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Paul, Mical (author)
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Carmeli, Yehuda (author)
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(creator_code:org_t)
- 2019-11-23
- 2020
- English.
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In: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1058-4838 .- 1537-6591. ; 71:10, s. 2599-2607
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: We evaluated whether carbapenem-colistin combination therapy given to patients with infections due to carbapenem-resistant Gram-negative organisms reduces the emergence of colistin resistance compared to colistin monotherapy.METHODS: This is a pre-planned analysis of a secondary outcome from a randomized controlled trial comparing colistin monotherapy with colistin-meropenem combination for the treatment of severe infections caused by carbapenem-resistant, colistin-susceptible Gram-negative bacteria. We evaluated rectal swabs taken on day 7 from enrollment or later for the presence of new colistin-resistant (ColR) isolates. We evaluated the emergence of any ColR isolate and the emergence of ColR Enterobacteriaceae (ColR-E).RESULTS: Data were available for 214 patients for the primary analysis; emergent ColR organisms were detected in 22 (10.3%). No difference was observed between patients randomized to treatment with colistin monotherapy (10/106, 9.4%) vs. patients randomized to colistin-meropenem combination therapy (12/108, 11.1%), p=0.669. ColR-E organisms were detected in 18/249 (7.2%) patients available for analysis. No difference was observed between the two treatment arms (colistin monotherapy 6/128 [4.7%] vs. combination therapy 12/121 [9.9%], p=0.111). Enterobacteriaceae as the index isolate was found to be associated with development of ColR-E (HR 3.875 95% CI 1.475-10.184, p=0.006).CONCLUSIONS: Carbapenem-colistin combination therapy did not reduce the incidence of colistin resistance emergence in patients with infections due to carbapenem-resistant organisms. Further studies are necessary to elucidate the development of colistin resistance and methods for its prevention.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- Carbapenem
- Colistin
- Enterobacteriaceae
- Gram-negative
- Resistance
Publication and Content Type
- ref (subject category)
- art (subject category)
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Dickstein, Yaako ...
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Lellouche, Jonat ...
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Schwartz, David
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Nutman, Amir
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Rakovitsky, Nady ...
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Dishon Benattar, ...
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show more...
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Altunin, Sergey
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Bernardo, Marian ...
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Iossa, Domenico
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Durante-Mangoni, ...
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Antoniadou, Anas ...
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Skiada, Anna
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Deliolanis, Ioan ...
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Daikos, George L
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Daitch, Vered
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Yahav, Dafna
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Leibovici, Leona ...
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Rognås, Viktor
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Friberg, Lena E.
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Mouton, Johan W
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Paul, Mical
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Carmeli, Yehuda
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show less...
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Clinical Infecti ...
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Uppsala University