In 36% of patients with pneumonia requiring mechanical ventilation, the cause is bacterial infection. pseudomonas aeruginosa resistant to treatment, according to data from a recent study conducted in Italy, Greece and Spain. And that’s it, Although new drugs and tools have been developed to combat multi-resistant bacteria, the truth is that it has been observed that, sometimes, resistance to these new drugs also begins to appear, which in some cases has prevented professionals from Have been forced to resort to antibiotics. To deal with these infections ancient,
it This is the case of colistin, an antibiotic from the 1950s whose use was abandoned due to its high toxicity, which had to be recovered to treat patients with pneumonia caused by coronavirus infection. pseudomonas aeruginosa resistant to treatment,
About this, “The problem of bacterial multi-resistance to antibiotics is real and growing,” explains Dr. Lulisa Sorli, associate physician in the Infectious Disease Service at Hospital del Mar. “As new drugs come out, they have a few years of shelf life.” “Life exists, but bacteria are becoming resistant.” “Currently, we have new drugs that have come into hospitals in the last 5 or 10 years that can save us from using this old drug, but not all hospitals have access to these new drugs and we are already We find that, sometimes, these bacteria become resistant even to the new drugs and hence, we have to resort to colistin again.” The problem with this practice is that, At high doses, this medicine can be toxic to the kidneys.
In this context, researchers from the Infectious Pathology and Antimicrobial Research Group of the Hospital del Mar Research Institute have conducted a study, the results of which have just been published in the journal Microbiology Spectrum, which shows that not only increasing the dose of colistin is effective in the treatment of infections. is not useful, but may increase mortality in patients.
In this work, in which researchers from CIBER for Infectious Diseases, Monash University of Melbourne and the Reference Laboratory of Catalonia also participated, the levels of this drug were analyzed in the plasma of patients treated for pneumonia at the Hospital del Mar. caused by bacterial infection pseudomonas aeruginosa found resistant to antibiotics and Those with higher levels did not develop better and, on the contrary, increased mortality.
In this regard, Dr. Lulisa Sorli, principal investigator of the study, comments that “Over the last 20 years, we had learned that to treat serious infections we have to use higher levels of antibiotics to achieve higher levels of The blood always finds a balance between dose and kidney toxicity, however, in this study we saw the opposite: the fact that blood levels are higher in patients not only means that the infection does not get better, Rather, “They were dying, which ruins everything we had seen in recent years.”
Given this evidence, researchers suggest that patients with pneumonia caused by bacterial infections should be able to offer pseudomonas aeruginosa Antibiotic resistant best approach, The route of administration should be changed, the intravenous route should be abandoned as a last resort and administration by nebulization should be preferred.Because in this way it is possible to concentrate colistin in the lungs, where the infection is located, and prevent it from getting into the blood and, as a result, affecting the kidneys.
“Our group has shown that administration of colistin by inhalation achieves very high levels of it in the lungs, which makes us interested in treating pneumonia, and there is no risk of toxicity when we administer it by the route. Systemic,” comment the doctor, who points out that these findings can also be applied to “approaches to other infections caused by treatment-resistant bacteria.”