PDF(Pubmed)
Abstract：
UNASSIGNED: Colistin is considered a valuable and last-resort therapeutic option for MDR gram-negative bacteria. Nephrotoxicity is the most clinically pertinent adverse effect of colistin. Vivo studies suggest that administering oxidative stress-reducing agents, such as ascorbic acid, is a promising strategy to overcome colistin-induced nephrotoxicity (CIN). However, limited clinical data explores the potential benefit of adjunctive ascorbic acid therapy for preventing CIN. Therefore, this study aims to assess the potential nephroprotective role of ascorbic acid as adjunctive therapy against CIN in critically ill patients.
UNASSIGNED: This was a retrospective cohort study at King Abdulaziz Medical City (KAMC) for all critically ill adult patients who received IV colistin. Eligible patients were classified into two groups based on the ascorbic acid use as concomitant therapy within three days of colistin initiation. The primary outcome was CIN odds after colistin initiation, while the secondary outcomes were 30-day mortality, in-hospital mortality, ICU, and hospital LOS. Propensity score (PS) matching was used (1:1 ratio) based on the patient\'s age, SOFA score, and serum creatinine.
UNASSIGNED: A total of 451 patients were screened for eligibility; 90 patients were included after propensity score matching based on the selected criteria. The odds of developing CIN after colistin initiation were similar between patients who received ascorbic acid (AA) as adjunctive therapy compared to patients who did not (OR (95 %CI): 0.83 (0.33, 2.10), p-value = 0.68). In addition, the 30-day mortality, in-hospital mortality, ICU, and hospital LOS were similar between the two groups.
UNASSIGNED: Adjunctive use of Ascorbic acid during colistin therapy was not associated with lower odds of CIN. Further studies with a larger sample size are required to confirm these findings.
UNASSIGNED: This was a retrospective cohort study at King Abdulaziz Medical City (KAMC) for all critically ill adult patients who received IV colistin. Eligible patients were classified into two groups based on the ascorbic acid use as concomitant therapy within three days of colistin initiation. The primary outcome was CIN odds after colistin initiation, while the secondary outcomes were 30-day mortality, in-hospital mortality, ICU, and hospital LOS. Propensity score (PS) matching was used (1:1 ratio) based on the patient\'s age, SOFA score, and serum creatinine.
UNASSIGNED: A total of 451 patients were screened for eligibility; 90 patients were included after propensity score matching based on the selected criteria. The odds of developing CIN after colistin initiation were similar between patients who received ascorbic acid (AA) as adjunctive therapy compared to patients who did not (OR (95 %CI): 0.83 (0.33, 2.10), p-value = 0.68). In addition, the 30-day mortality, in-hospital mortality, ICU, and hospital LOS were similar between the two groups.
UNASSIGNED: Adjunctive use of Ascorbic acid during colistin therapy was not associated with lower odds of CIN. Further studies with a larger sample size are required to confirm these findings.
摘要：
未经证实：粘菌素被认为是治疗MDR革兰氏阴性菌的一种有价值和最后手段的治疗选择。肾毒性是粘菌素临床上最相关的不良反应。体内研究表明，施用氧化应激降低剂，比如抗坏血酸，是克服粘菌素诱导的肾毒性（CIN）的有希望的策略。然而,有限的临床数据探讨了辅助抗坏血酸治疗预防CI的潜在益处。因此,本研究旨在评估在危重患者中,抗坏血酸作为辅助治疗CIN的潜在肾保护作用.
UNASSIGNED：本研究是在阿卜杜勒阿齐兹国王医疗城（KAMC）进行的一项回顾性队列研究，研究对象是所有接受静脉粘菌素治疗的成年危重患者。根据在粘菌素开始后三天内使用抗坏血酸作为伴随疗法，将符合条件的患者分为两组。主要结果是粘菌素启动后的CIN几率，而次要结局是30天死亡率，住院死亡率，ICU,医院LOS根据患者的年龄使用倾向评分(PS)匹配(1:1比例)，SOFA得分,还有血清肌酐.
UNASSIGNED：共筛选451名患者是否符合资格；90名患者根据所选标准进行倾向评分匹配后纳入。与未接受抗坏血酸（AA）辅助治疗的患者相比，粘菌素开始后发生CIN的几率相似（OR（95CI）：0.83（0.33，2.10），p值=0.68)。此外,30天死亡率，住院死亡率，ICU,两组的住院LOS相似.
未经证实：在粘菌素治疗期间辅助使用抗坏血酸与较低的CI几率无关。需要更大样本量的进一步研究来证实这些发现。
UNASSIGNED：本研究是在阿卜杜勒阿齐兹国王医疗城（KAMC）进行的一项回顾性队列研究，研究对象是所有接受静脉粘菌素治疗的成年危重患者。根据在粘菌素开始后三天内使用抗坏血酸作为伴随疗法，将符合条件的患者分为两组。主要结果是粘菌素启动后的CIN几率，而次要结局是30天死亡率，住院死亡率，ICU,医院LOS根据患者的年龄使用倾向评分(PS)匹配(1:1比例)，SOFA得分,还有血清肌酐.
UNASSIGNED：共筛选451名患者是否符合资格；90名患者根据所选标准进行倾向评分匹配后纳入。与未接受抗坏血酸（AA）辅助治疗的患者相比，粘菌素开始后发生CIN的几率相似（OR（95CI）：0.83（0.33，2.10），p值=0.68)。此外,30天死亡率，住院死亡率，ICU,两组的住院LOS相似.
未经证实：在粘菌素治疗期间辅助使用抗坏血酸与较低的CI几率无关。需要更大样本量的进一步研究来证实这些发现。
