From the Guidelines
Colistin should not be used as a first-line treatment for New Delhi Metallo-beta-lactamase (NDM) producing organisms due to its limited efficacy and high mortality rates associated with its use, as evidenced by a recent observational study 1. The study found that patients treated with colistin-containing regimens had the highest mortality rates compared to those treated with other antibiotics, including ceftazidime/avibactam plus aztreonam, which showed significantly lower 30-day mortality rates 1. Some key points to consider when treating NDM-producing organisms include:
- The use of ceftazidime/avibactam plus aztreonam is recommended as a first-line treatment due to its in vitro synergy and improved clinical outcomes 1.
- Cefiderocol may be considered as an alternative option, with recent studies showing promising results in terms of clinical cure and microbiological eradication 1.
- The development of efficient MBL inhibitors is ongoing, and cefiderocol appears to be a promising therapeutic option, but its use against MBLs requires further investigation due to concerns about high MIC values, treatment-emergent resistance, and the role of combination therapy 1. It is essential to prioritize the use of antibiotics with proven efficacy against NDM-producing organisms to minimize morbidity, mortality, and improve quality of life. In the context of real-life clinical medicine, the choice of antibiotic should be guided by the most recent and highest-quality evidence available, and colistin should only be considered when other options are not available or have failed.
From the Research
Coverage of Colistin (Colistimethate) against New Delhi Metallo-beta-lactamase (NDM) producing organisms
- There are no research papers to assist in answering this question as the provided studies do not mention Colistin (Colistimethate) in the context of treating New Delhi Metallo-beta-lactamase (NDM) producing organisms 2, 3, 4, 5, 6.
- The studies focus on the treatment of NDM-producing organisms using other antibiotics such as ceftazidime-avibactam, aztreonam, and tigecycline 2, 3, 5, 6.
- One study discusses the development of NDM inhibitors, but it does not mention Colistin (Colistimethate) as a potential inhibitor 4.