Clinical efficacy and risk factors of colistin sulfate in the treatment of carbapenem-resistant Gram-negative bacilli infections: A retrospective study.

OBJECTIVES: Infections caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) have become a global public health concern because of their high incidence and mortality. Although intravenous colistin sulfate has been widely used for the treatment of CR-GNB infections, systematic evaluations of its clinical efficacy and safety remain limited. This study aims to evaluate the clinical efficacy and safety of colistin sulfate in the treatment of CR-GNB infections and to analyze factors associated with therapeutic efficacy and prognosis, thereby providing evidence for rational clinical use and improved patient outcomes. METHODS: Clinical data of patients from the Third Xiangya Hospital of Central South University who received intravenous colistin sulfate for CR-GNB infections between July 2020 and March 2023 were retrospectively collected, including demographic characteristics, infection-related information (infection sites, pathogens, and antimicrobial susceptibility results), concomitant medications (drug type, dosage, and treatment duration), laboratory findings, and patient outcomes. The clinical efficacy and safety of colistin sulfate for CR-GNB infections were evaluated, and the 30‑day all‑cause mortality and microbiological eradication rate were analyzed. Multivariable Logistic regression analysis was performed to identify independent risk factors affecting the clinical efficacy of colistin sulfate treatment and to construct a predictive model. The predictive performance of the model was assessed using the area under the receiver operating characteristic curve (AUROC). Kaplan‑Meier curves and Cox regression models were used to analyze factors associated with 30-day all-cause mortality. RESULTS: =0.031) were independently associated with lower 30-day all-cause mortality. CONCLUSIONS: Colistin sulfate is effective in the treatment of CR-GNB infections. Treatment duration ≥7 d is an independent factor associated with improved clinical efficacy and survival. During adequate treatment courses, the emergence of colistin resistance should be closely monitored, and combination regimens should be selected according to antimicrobial susceptibility results.