Evidence map›Paper›PMID 40140752›Full record

Observational studyBMC infectious diseases2025

Mortality and clinical outcomes of colistin versus colistin-based combination therapy for infections caused by Multidrug-resistant Acinetobacter baumannii in critically ill patients.

Marwan J Alwazzeh, Jumanah Algazaq, Fatimah Ali Al-Salem, Fatimah Alabkari, Sara M Alwarthan, Mashael Alhajri, Bashayer M AlShehail, Amani Alnimr, Ahmad Wajeeh Alrefaai, Faten Hussain Alsaihati and 1 more

Abstract readObservational StudyComparative Study
In one paragraph

Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Colistin therapy and survival outcomes in neonatal carbapenem-resistant gram-negative sepsis.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2026
    Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Review
  7. Caerin 1.1/1.9 peptides controlFrontiers in microbiology · 2026
    Article
  8. Multidrug-ResistantAntibiotics (Basel, Switzerland) · 2025
    Review
  9. TargetingInternational journal of molecular sciences · 2025
    Article
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Marwan J AlwazzehInfectious Disease Division, Department of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, & King Fahad Hospital of the University, Al Khobar, Saudi Arabia. mjalwazzeh@iau.edu.sa.ORCID http://orcid.org/0000-0002-4646-6717
Jumanah AlgazaqInfectious Disease Division, Department of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, & King Fahad Hospital of the University, Al Khobar, Saudi Arabia.ORCID http://orcid.org/0000-0003-4774-8975
Fatimah Ali Al-SalemInfectious Disease Division, Department of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, & King Fahad Hospital of the University, Al Khobar, Saudi Arabia.ORCID http://orcid.org/0009-0005-9779-8024
Fatimah AlabkariInfectious Disease Division, Department of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, & King Fahad Hospital of the University, Al Khobar, Saudi Arabia.
Sara M AlwarthanInfectious Disease Division, Department of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, & King Fahad Hospital of the University, Al Khobar, Saudi Arabia.ORCID http://orcid.org/0000-0001-5061-8560
Mashael AlhajriInfectious Disease Division, Department of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, & King Fahad Hospital of the University, Al Khobar, Saudi Arabia.ORCID http://orcid.org/0000-0002-9325-0281
Bashayer M AlShehailPharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.ORCID http://orcid.org/0000-0003-2372-9462
Amani AlnimrDepartment of Microbiology, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.ORCID http://orcid.org/0000-0001-5105-6002
Ahmad Wajeeh AlrefaaiDepartment of Microbiology, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.ORCID http://orcid.org/0009-0001-5370-9094
Faten Hussain AlsaihatiDepartment of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Fahad Hospital of the University, Dammam & King, Al Khobar, Saudi Arabia.ORCID http://orcid.org/0009-0003-8343-8226
Fahd Abdulaziz AlmuhannaNephrology Division, Department of Internal Medicine, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Fahad Hospital of the University, Dammam & King, Al-Khobar, Saudi Arabia.ORCID http://orcid.org/0000-0003-2169-8391

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultidrug-resistant Acinetobacter baumannii emerged as a threatening "superbug" with significant morbidity and mortality and limited antimicrobial therapy options. The results of different antibiotic combination studies are heterogeneous and controversial. Further comparative studies are crucial to overcome such difficult-to-treat infections and to improve patient outcomes. This study investigates the mortality and outcomes of colistin versus colistin-based combination therapy for infections caused by Multidrug-resistant Acinetobacter baumannii in critically ill patients.

methodsA retrospective observational study was conducted at an academic tertiary hospital in Khobar City, Eastern Province, Saudi Arabia. Patients who fulfilled the inclusion criteria and were admitted from January 1, 2017, to December 31, 2022, were included. The investigated primary outcome was 30-day mortality, while secondary outcomes were one-year all-cause mortality, clinical cure, microbiologic eradication, and recurrence of Acinetobacter infections. Statistical comparisons were employed, and a P-value of ≤ .05 was considered significant.

resultsOf the 178 patients who fulfilled the inclusion criteria, 47 received colistin only, and 131 received colistin in combinations (55 with carbapenems, 53 with tigecycline, and 23 with both). The estimated 30-day mortality rate of the study population was 22.5%, with statistically insignificant differences in 30-day mortality rates when the colistin group compared to cumulative colistin-based combination (23.4% vs. 22.1%; difference, 1.3 percentage points; 95% confidence interval [CI], 0.487-2.371; P = 0.858) or subgroups. However, colistin-based combination groups showed better secondary outcomes, with significantly less all-cause mortality and better clinical cure in colistin combination with carbapenems or tigecycline and less Acinetobacter infection recurrence in combination with carbapenems.

conclusionsThe study findings demonstrate the benefits of investigated colistin combination options that result in less one-year all-cause mortality, better clinical cure, higher microbiologic response, and less infection recurrence. However, no significant differences were observed regarding 30-day mortality. In addition, the study highlights the limitations of the available antimicrobial options and the crucial need for new effective antimicrobials and more successful combinations.

Indexed as

Acinetobacter baumanniiAcinetobacter InfectionsAnti-Bacterial AgentsColistinDrug Resistance, Multiple, BacterialAdultAgedCarbapenemsCritical IllnessDrug Therapy, CombinationFemaleHumansMaleMiddle AgedRetrospective StudiesSaudi ArabiaAnti-Bacterial AgentsCarbapenemsColistinAcinetobacter baumanniiCarbapenemColistinCombinationOutcomeTigecycline

Identifiers

PMID40140752
PMCPMC11948640

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.