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Old agent, new experience: colistin use in the paediatric Intensive Care Unit--a multicentre study

Muhammet Sukru Paksu1, Sule Paksu, Adil Karadag

  • 1Ondokuz Mayis University, Faculty of Medicine, Pediatric Intensive Care Unit, Samsun, Turkey. sukrupaksu@yahoo.com

International Journal of Antimicrobial Agents
|June 26, 2012
PubMed

Insights

Colistin effectively treats severe nosocomial infections in children caused by multidrug-resistant Gram-negative bacteria. This antibiotic demonstrated a high favorable outcome rate with generally good tolerability, even in long-term use.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • Nosocomial infections caused by multidrug-resistant (MDR) microorganisms pose a significant global health challenge, particularly in pediatric Intensive Care Units (ICUs).
  • Effective therapeutic options for severe infections caused by MDR Gram-negative bacteria in critically ill children are limited.

Purpose of the Study:

  • To evaluate the efficacy and safety of intravenous colistin therapy in pediatric patients diagnosed with severe nosocomial infections.
  • To assess the outcomes of colistin treatment for infections caused by multidrug-resistant Gram-negative bacteria in a pediatric Intensive Care Unit (ICU) setting.

Main Methods:

  • A retrospective study involving 79 pediatric ICU patients across five hospitals, encompassing 87 episodes of severe nosocomial infections.
  • Patients received intravenous colistin; data on demographics, causative pathogens, infection types, treatment duration, dosage, and clinical outcomes were collected and analyzed.
  • Key pathogens identified included Acinetobacter baumannii, with ventilator-associated pneumonia being the most common infection type.

Main Results:

  • Colistin therapy resulted in a favorable outcome in 83.9% of the evaluated patient episodes.
  • Serious adverse events were infrequent (4.6%), including renal failure and convulsive seizures in a small number of patients.
  • The infection-related mortality rate was 11.5%, with a higher probability of death observed within the first 9 days of treatment.

Conclusions:

  • Colistin is an effective treatment option for severe nosocomial infections caused by multidrug-resistant Gram-negative bacteria in pediatric patients.
  • The drug is generally well-tolerated, even with relatively long treatment durations, suggesting a favorable safety profile in this population.
  • Early initiation of colistin therapy may be crucial for improving survival rates in critically ill pediatric patients with MDR Gram-negative infections.

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