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

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.