Colistin sulfate is effective and safe in the treatment of severe pneumonia patients with CRE resistance: a retrospective cohort study

Objective Severe pneumonia is difficult to treat and with a high mortality. The increasing drug resistance problem increased the difficulties to treat, so we estimated whether colistin sulfate reduces the mortality of severe pneumonia patients with suspicious CRO infection. Method A retrospective cohort study was conducted on the patients consecutively admitted for pneumonia to the Second Affiliated Hospital of Chongqing Medical University from Jan 2022 to Feb 2023. Data were recorded. Results We found that the 28-day mortality after discharge of severe pneumonia patients with suspected MDR bacterial infections in our cohort study is also high (42/84, 50%). The 28-day mortality of discharge in tigecycline (TC) group is a bit lower than that of colistin combined with other antibiotics (OC) group (18/46, 39.1% vs. 24/38, 63.2%, P = 0.048). Further multivariate analysis revealed that positive sputum culture was significantly associated with the 28-day discharge mortality rate with different treatment regimens (OR 0.073, 95% CI 0.006–0.882, P = 0.040). And no significant differences were founded before and after the use of colistin sulfate for the white blood count (WBC), platelet count, level of CRP, PCT, ALT, and creatinine. Conclusion Colistin sulfate is effective and safe in the treatment of severe pneumonia patients with CRE resistance.