Disclaimer: The information in this article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. We encourage you to seek expert guidance before making any medical decisions.
If you or a loved one has ever faced a severe infection while also dealing with kidney problems, you’ll know just how complicated and nerve-wracking treatment decisions can be.
Now, a new study is shining a light on how to better treat critically-ill patients with both acute kidney injury and life-threatening infections, potentially changing the way doctors prescribe antibiotics for some of the sickest patients in our hospitals.
Let’s set the scene: Colistin is a powerful antibiotic, often used as a last resort when other drugs fail against tough, multidrug-resistant infections like pneumonia or bloodstream infections.
It’s a real lifesaver, but it comes with its own set of challenges, especially for patients whose kidneys aren’t working correctly and who need dialysis to survive.
Colistin is given as an inactive form called colistin methanesulfonate (CMS), which the body converts into the active antibiotic.
But here’s the tricky part: when patients are on sustained low-efficiency dialysis (SLED), their bodies dramatically change how they process and eliminate colistin.
What did the study find?
Researchers from Monash University and Mahidol University followed 13 critically ill patients receiving both CMS and SLED.
They carefully measured how much of the drug and its active form were present in the blood and urine on days with and without dialysis.
The results were eye-opening: SLED caused the body to clear out CMS and colistin much faster than on non-dialysis days.
If doctors give the same dose of colistin on dialysis days as on non-dialysis days, patients might not get enough of the drug to fight off their infection.
The study’s simulations showed that higher doses are needed on SLED days to keep the antibiotic at adequate levels.
What’s new about this research?
One of the study’s authors, Associate Professor Cornelia Landersdorfer, said: ‘This study is the first to examine CMS and colistin disposition exclusively in patients undergoing SLED by applying population pharmacokinetic modelling, and enrolled 13 patients, making it an important development for clinicians and patients alike.’
This is the first study to use advanced population pharmacokinetic modelling to look specifically at how CMS and colistin behave in patients on SLED.
It’s a big step forward, as previous guidelines were based on limited information, leaving doctors to make educated guesses about dosing.
Thanks to this research, clinicians now have a more precise roadmap for adjusting antibiotic doses for patients on this type of dialysis.
The researchers hope their findings will soon be implemented in hospitals.
‘There is currently very little information on the handling of CMS and colistin in critically-ill patients on days when SLED is undertaken, so we are excited to publish our findings and contribute to enhancing dosing regimens for such patients,’ Dr Adhiratha Boonyasiri, one of the lead authors, said.
This could mean better outcomes, fewer complications, and a higher chance of beating those stubborn infections.
While this study is a leap forward, it’s important to remember that antibiotic dosing is complex and should always be managed by a medical professional.
With antibiotic resistance on the rise, research like this is crucial. It helps protect vulnerable patients and ensures that our most potent drugs remain effective for years to come.
Have you or a loved one ever had to navigate complex treatments in the hospital, especially with kidney issues or tough infections? Did you feel confident in the care you received, or were there moments you wished you had more information? Share your experiences and thoughts in the comments below.
Also read: New Australian data shows most of us have PFAS in our blood. How worried should we be?
