Single Dose of Collistin and Dramatic Improvement in Klebsiella Sensitivity Pattern

A 57 year old woman with diabetes and uncontrolled blood sugars had an MDR urinary tract infection and was sensitive only to colistin and tigecycline (figure 1-3). Her weight is around 60 KG. Her eGFR was 42 mL/min/1.73 m2.

Based on the Urine C/S report, one shot of colistin 9 million units was given and as the patient couldn't afford any further therapy and just after one shot of colistin subjectively she was much better, so collistin was stopped.

In this case the patient had a short window of opportunity to benefit from just a single shot of colistin which was serendipity as at that point of time we didn't know that she wouldn't be able to afford the subsequent doses. Once she said that her symptoms had reduced dramatically with that one shot of colistin we felt that this was our window of opportunity as we needed to check out what was happening to the MDR klebsiella inside her and repeat urine culture sensitivity now showing that a klebsiella dramatically changed its sensitivity pattern after one single dose (figure 4).

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