Colymisin treatment effectiveness by loading dose in infections caused by multiresistant gram-negative bacteria

Objectives: The main objective of this study is to determine the efficacy of loading-treated colistin therapy in infections with multidrug-resistant gram-negative bacteria. In other words, to determine the effect of colimycin loading on infections occured by multidrug-resistant gram-negative bacteria. It is also investigated whether there is a relationship between colimycin loading with mortality, culture negativity, and nephrotoxicity and neurotoxicity side effects. In addition to the relationship between these variables, the aim is also to find out whether there is a decrease or increase between the initial CRP and the last CRP values and the initial PCT and the last PCT values of the patients who are taken colimycin. Method: Quantitative analysis method was used to test the hypothesis of the research and to investigate the relationship between variables.Within the scope of this analysis, SPSS (21.0) program was used to analyze data of variables, demographic characteristics such as age, gender,the risk factors that the patients had.After the frequency analysis was tested, the test of normality was first performed for all variables. Non-parametric analysis techniques were used because the data were not normally distributed. Chi-Square test was performed to find the effect of independent variables (colistin loading) on dependent variables (mortality, microbiyolgical response, and nephrotoxicity and neurotoxicity side effects). Moreover, the Wilcoxon test was used to find the relation between variables (CRP andPCT values). Sample: In order to make a retrospective comparison of the colistin activity between 2011 and 2014 with the years between 2015 and 2017 retrospective comparison, it is aimed to investigate the effects of hospital infections on hospitalized infections - bacteremia, pneumonia, urinary system infections, soft tissue infections, central nervous system infections, other infectious colistin the patients were taken to the study with permission of the sample Findings: Multidrug-resistant bacteria are more common in hospital infections. In this study, after being hospitalized, patients were loaded colimysin. 95.6% of patients had used an antibiotic. The majority of the patients included in the study were 62 year old (52,3%) and 66.9%, were male. Of the patients, 39.9% were hospitalized in the anesthesia intensive care department, and most of these patients were hospitalized for less than 30 days. The result of the treatment resulted by Ex (60.4%). Most of patients had neurological disorder in their past (25.5%). The most common risk for these patients was to use an antibiotic (10.7%) and peripheral venous catheter (10.6%). Acinetobacter spp (58.5%) was the main bacteria cause of using colimysin and XDR was the most common resistant to those bacteria (74.9%). One of the most common causes of using colimysin is HGP / VIP (48.9%). The nephrotoxicity side effect was seen in patients about 53.3% and this effect was occured in the first three days (18.0%). Microbiological response was seen in patients (39.6%) that response was occurred between 4 and 7 days (13.6%). 99 patients used just colimycin (30.7%), and 168 patients used colimysin with combination at least one antibiotic (52.0%) while 56 (17.3%) patients combinated colimysin with two or three antibiotics. Results: The effect of colimycin loading on nephrotoxicity, neurotoxicity, and treatment outcome was statistically significant at the 95% confidence interval (p <0.05).However, the effect of colimycin loading on culture-negative was not significant (p> 0.05). Both initial and last c reactive protein (CRP) and Procalcitonin (PCT) decrease was seen between first and last values. This shows that there is a significant effect on the reduction of CRP and PCT values with colimycin loading. Keywords: Colimycin, Gram Negative Bacteria, Infection