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Cost-effectiveness analysis of low versus high dose colistin in the treatment of multi-drug resistant pneumonia: a comment

  • Effat Davoudi-Monfared
  • Maryam Taghizadeh-GhehiEmail author
Letter to the Editor
  • 31 Downloads

To the editor

We read with great interest the article by Cara et al. [1] in a recently published issue of the International Journal of Clinical Pharmacy. This study was conducted to evaluate cost-effectiveness of high dose versus low dose colistin (HDC vs. LDC) in treatment of nosocomial pneumonia (NP) due to multidrug resistant gram-negative bacteria (MDR-GNB). The authors concluded that LDC is as effective as and less nephrotoxic than HDC and could be considered as a cost-effective treatment for MDR-GNB NP. The study topic is important; however we faced issues in the study methodology and interpretation of results that need to be highlighted.

A major concern arises from considering LDC as a previously proven approach in treatment of MDR-GNB NP. In this study, doses less than 2.5 mg/kg were considered as LDC and doses above 2.5 mg/kg were defined as HDC. Three studies were cited in the paper as the basis for proven efficacy of LDC. The first citation belongs the study by Kalin et al. [

Notes

Conflicts of interest

The authors have nothing to declare.

References

  1. 1.
    Cara AKS, Zaidi STR, Suleman F. Cost-effectiveness analysis of low versus high dose colistin in the treatment of multi-drug resistant pneumonia in Saudi Arabia. Int J Clin Pharm. 2018;40(5):1051–8.CrossRefGoogle Scholar
  2. 2.
    Kalin G, Alp E, Coskun R, Demiraslan H, Gündogan K, Doganay M. Use of high-dose IV and aerosolized colistin for the treatment of multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia: do we really need this treatment? J Infect Chemother. 2012;18(6):872–7.CrossRefGoogle Scholar
  3. 3.
    Zaidi STR, Al Omran S, Al Aithan ASM, Al Sultan M. Efficacy and safety of low-dose colistin in the treatment for infections caused by multidrug-resistant gram-negative bacteria. J Clin Pharm Ther. 2014;39(3):272–6.CrossRefGoogle Scholar
  4. 4.
    Musher DM. Clinical and microbiological end points in the treatment of pneumonia. Clin Infect Dis. 2008;47(Supplement_3):S207–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Clinical Pharmacy, Faculty of PharmacyTehran University of Medical SciencesTehranIran
  2. 2.Research Center for Rational Use of DrugsTehran University of Medical SciencesTehranIran

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