The effects of vitamin E on colistin-induced nephrotoxicity in treatment of drug-resistant gram-negative bacterial infections: A randomized clinical trial

J Infect Chemother. 2021 Aug;27(8):1181-1185. doi: 10.1016/j.jiac.2021.03.013. Epub 2021 Apr 15.

Abstract

Introduction: Nephrotoxicity remains a major long-standing concern for colistin, and it is critical to find agents that can prevent it. The present study aims to investigate the effect of vitamin E on the prevention of colistin-induced nephrotoxicity based on its antioxidant and free radical scavenging properties.

Methods: A randomized clinical trial was designed for 52 patients taking colistin. These patients were categorized into two groups of equal size, receiving colistin or colistin plus vitamin E (α-Tocopherol). Vitamin E with doses of 400 units was administrated daily either orally or by a nasogastric tube if needed. The incidence of Acute Kidney Injury (AKI) and its duration was recorded based on RIFLE criteria.

Results: The Incidence of AKI based on RIFLE criteria was 42.3% and 46.2% in intervention and control groups, respectively. The analysis showed no significant difference in the prevalence of AKI for the two groups (P = 0.78). There was no significant difference in the duration of AKI neither (P = 0.83).

Conclusion: Although vitamin E is a powerful biological antioxidant, the effects of Vitamin E prophylaxis on colistin-induced nephrotoxicity was not taken into consideration in this study.

Keywords: Acute kidney injury; Colistin; Nephrotoxicity; Prophylaxis; Vitamin E.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / drug therapy
  • Acute Kidney Injury* / prevention & control
  • Anti-Bacterial Agents / adverse effects
  • Colistin / adverse effects
  • Gram-Negative Bacterial Infections* / drug therapy
  • Humans
  • Pharmaceutical Preparations*
  • Retrospective Studies
  • Risk Factors
  • Vitamin E / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Pharmaceutical Preparations
  • Vitamin E
  • Colistin