Data from: Clinical outcomes and safety of polymyxin B versus tigecycline combination therapy for pneumonia of carbapenem-resistant Klebsiella pneumoniae: A retrospective cohort study

Purpose: Infection by carbapenem-resistant Klebsiella
pneumoniae (CRKP) has high mortality. There is
no clear optimal therapeutic choice for pneumonia caused by CRKP. The aim
of this study was to compare the clinical outcomes and safety of the
standard doses of polymyxin B-based regimens vs
tigecycline-based regimens and to identify risk factors for
mortality. Methods: This retrospective cohort study included
patients with pneumonia caused by CRKP for three years. The primary
outcomes were 7-day bacterial eradication rate and 14- and 28-day
all-cause mortality. The secondary outcome was incidence of acute kidney
injury. Results: Seventy-three patients were included in
this study, 29 in the polymyxin B-based combination therapy group
and 44 in tigecycline-based combination therapy
group. There were no significant differences between the two
groups in terms of the 7-day bacterial eradication rate
(31.0% vs 20.5%, P=0.409), the 14-day
all-cause mortality (37.9% vs
22.7%, P=0.160), and the incidence of acute
kidney injury (14.3% vs
6.8%, P=0.526). The 28-day
all-cause mortality in the polymyxin B-based
therapy group was higher than in the
tigecycline-based group (75.9% vs
45.5%, P=0.010). Binary logistic regression analysis
revealed that male and previous use of carbapenems were
independent factors associated with 28-day all-cause
mortality for patients treated with polymyxin B (P＜0.05).
Conclusions: Polymyxin B-based combination therapy
at the standard dose should be used with caution
for patients with CRKP-induced pneumonia, especially for
men who used carbapenems prior to CRKP detection.