Akademik Veri Yönetim Sistemi
Medicine, cilt.104, sa.39, 2025 (SCI-Expanded)
This study aimed to investigate the prognostic factors of febrile neutropenic patients during colistin treatment. The indications for starting colistin treatment during febrile neutropenia (FN) episodes, nephrotoxicity, FN-related mortality rates, and the presence of isolated gram-negative bacteria in cultures were examined before initiating colistin treatment. This study included a total of 160 participants. The time from fever onset to colistin initiation was ≤ 5 days in 23 patients and > 5 days in 137 patients. When colistin treatment was initiated, 70 patients had sepsis or septic shock. There were 24% of patients had invasive pulmonary aspergillosis. Acute kidney injury occurred in 38 patients (24%). Klebsiella pneumoniae (41%), Acinetobacter baumannii (30%), and Escherichia coli (19%) were the most frequently isolated gram-negative bacteria. When these variables were included in the multivariate Cox regression model, the risk of mortality increased if colistin was started after the fifth day (hazard ratio [HR], 7.78; 95% confidence interval [95% CI], 1.89-31.95), patients had sepsis or septic shock (HR, 5.02; 95% CI, 2.03-12.37), patients had K. pneumoniae (HR, 3.06; 95% CI, 1.06-8.82) and A. baumannii infection (HR, 10.37; 95% CI, 2.91-36.92), and whether the patient had probable invasive pulmonary aspergillosis (HR, 6.51; 95% CI, 1.99-21.22). Culture-positive patients had a higher FN-related mortality rate than culture-negative patients (P = .04). In the presence of prognostic factors in our risk model, the early initiation of colistin therapy may reduce mortality.