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

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

Open Access
|Jan 2021

Figures & Tables

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_

ParameterOdds ratio (95% confidence interval)p-value
Microbial eradication0.19 (0.06-0.58)0.003
Secondary bacterial infection0.17 (0.05-0.59)0.005
30-day mortality0.45 (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)
Mean64.1±16.163.9±14.3
Range (min-max)20-8620-870.950

Gender
Male3733
Female27240.993

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)
Mean18±4.818.3±5.5
Range (min-max)10–308–300.727

C-reactive protein (<10.0 mg/mL)
Mean161.7(112.8)139.2±105.3
Range (min-max)11.7–393.610.3–390.30.260

Procalcitonin (<0.1 ng/mL)
Mean7.5(17.3)7.4±14.4
Range (min-max)0.2–1140.1–68.50.976

White blood cell (4-11 K/μL)
Mean19.2(7.3)18.9±7.3
Range (min-max)9.7–46.111.1–47.60.823

Serum creatinine (0.8-1.4 mg/dL)
Mean1.6(0.5)1.5±0.5
Range (min-max)0.6–2.30.6–2.50.905

Extubation, reintubation and hospitalisation time of the patients

GroupTime to extubation, n (%)p-valueICU length-of-stay, n (%)p-value21-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)
DOI: https://doi.org/10.2478/jccm-2020-0044 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 28 - 36
Submitted on: Jul 15, 2020
Accepted on: Nov 23, 2020
Published on: Jan 29, 2021
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2021 Md. Jahidul Hasan, Raihan Rabbani, Ahmad Mursel Anam, Ario Santini, Shihan Mahmud Redwanul Huq, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.