Colistin Therapy Shows Promise in Cancer Patients with Multidrug-Resistant Gram-Negative Bacterial Infections

Strategic Insights -

Research conducted by Kyung Hee University in Seoul, South Korea, has investigated the effectiveness of colistin therapy in cancer patients with multidrug-resistant Gram-negative bacterial (MDR GNB) infections. The study, published in Medicina, aimed to evaluate the mortality risk associated with colistin versus non-colistin regimens in cancer patients with MDR GNB infections, stratified by resistance profiles, infection sites, and concomitant medication use.

Key Takeaways:

  • The study included 85 patients, with 29 patients in the colistin group and 56 patients in the non-colistin group, and found that colistin use did not show a statistically significant mortality benefit compared to non-colistin regimens (hazard ratio (HR) 0.93, 95% CI 0.47-1.87).
  • However, the subgroup analysis revealed that colistin had a potential association with significantly lower mortality in pneumonia patients with aminoglycoside-resistant infections (HR 0.04, 95% CI 0.002-0.69).
  • Concomitant use of antipsychotics and benzodiazepines in selected resistance profiles also correlated with improved outcomes, while concomitant macrolide use and increased mortality were found in patients with fluoroquinolone- or penicillin-resistant profiles.
  • The study concluded that colistin may offer survival benefits in selected high-risk cancer patients with MDR GNB pneumonia, and that treatment outcomes are influenced by resistance profiles, infection sites, and concomitant medications.
  • The study's findings highlight the importance of individualized antimicrobial therapy and antimicrobial stewardship in oncology patients.

Statistics:

  • 85 patients were included in the analysis, including 29 patients in the colistin group and 56 patients in the non-colistin group.
  • The hazard ratio (HR) for colistin use versus non-colistin regimens was 0.93 (95% CI 0.47-1.87).
  • The hazard ratio (HR) for colistin use in pneumonia patients with aminoglycoside-resistant infections was 0.04 (95% CI 0.002-0.69).
  • The percentage of patients with improved outcomes with concomitant use of antipsychotics and benzodiazepines was not specified.

Sources:

  • Mortality Risk of Colistin vs. Non-Colistin Use in Cancer Patients with Multidrug-Resistant Gram-Negative Bacterial Infections: Stratified by Resistance Profile and Concomitant Medications. Medicina, 2025,61(8):1361. (Medicina - http://www.mdpi.com/journal/medicina).
  • NewsRx. Researchers at Kyung Hee University Target Gram-Negative Bacterial Infections (Mortality Risk of Colistin vs. Non-Colistin Use in Cancer Patients with Multidrug-Resistant Gram-Negative Bacterial Infections: Stratified by Resistance Profile and ...). Respiratory Therapeutics Week. September 8, 2025; p 5654.