Publication date: May 13, 2025
Background and Objectives: Bacterial infections amongst COVID-19 patients could be associated with worsened outcomes. This study aimed to investigate the efficacy of colistin antibiotic in multidrug-resistant (MDR) Gram-negative (-ve) secondary bacterial infections among hospitalized COVID-19 patients. Materials and Methods: In this multicentered retrospective study, we analyzed data from the medical records of 116 patients diagnosed with COVID-19 infection and secondary Gram-negative MDR bacterial respiratory infections. Results: We compared those assigned to colistin versus non-colistin-based antimicrobial therapy. The two arms of the study were similar in baseline clinical features, demographics, and Gram-negative pathogens’ distribution. Acinetobacter baumannii (51. 7%) was the major pathogen, followed by Klebsiella pneumonia (26. 7%). Patients who received colistin-based antimicrobial regimen showed a non-significant difference compared to non-colistin antimicrobial (NCA) therapy (p > 0. 05) in the main outcomes. Nephrotoxicity was significantly higher in the IV colistin group, compared to the control (34. 1% and 15. 3%, p = 0. 018). There were substantial differences observed in the levels of serum creatinine and urea among the study arms (p = 0. 029 and