Colistin-Induced Acute Kidney Injury in the Treatment of Extensively Drug-Resistant Klebsiella Pneumoniae: A Case Report

This case report describes a 59-year-old male with uncontrolled type 2 diabetes mellitus who presented with recurrent urinary tract infections caused by multi-drug resistant Klebsiella pneumoniae. The patient's condition progressed from initial sensitivity to ceftazidime-avibactam to eventual resistance, leaving colistin as the only effective antibiotic. During the 19-day course of colistin therapy (900 mg daily), the patient developed severe acute kidney injury, with serum creatinine rising from 1.3 to 10.1 mg/dL, and colistin-induced peripheral neuropathy. Following discontinuation of colistin, partial renal recovery was observed, with creatinine decreasing to 2.5 mg/dL. This case highlights the challenges in managing extensively drug-resistant infections, the limited treatment options available, and the significant adverse effects associated with last-resort antibiotics like colistin. It underscores the urgent need for new antimicrobial strategies and emphasizes the importance of careful monitoring during treatment with potentially toxic antibiotics.