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Safety and efficacy of intravenous colistin in children

Poddutoor Preetham Kumar1, Swapnil Rameshwar Giri, Farhan A R Shaikh

  • 1Department of Intensive Care, Rainbow Childrens Hospital, Banjara Hills, Hyderabad, India. Correspondence to: Dr P Preetham Kumar C/o Rainbow Childrens Hospital, Banjara Hills, Hyderabad. 500034. drpreethamp@gmail.com.

Indian Pediatrics
|February 19, 2015
PubMed

Insights

Colistimethate sodium is a safe and effective treatment for children with gram-negative bacterial infections. This study found a high survival rate and low incidence of kidney injury, demonstrating its therapeutic value.

Area of Science:

  • Pediatric Infectious Diseases
  • Nephrology
  • Pharmacology

Background:

  • Gram-negative bacterial infections pose a significant threat to children.
  • Carbapenem resistance necessitates alternative antibiotic options.
  • Colistimethate sodium is a last-resort antibiotic for multidrug-resistant Gram-negative infections.

Purpose of the Study:

  • To evaluate the safety and efficacy of colistimethate sodium in pediatric patients.
  • To assess renal safety using pediatric Risk, Injury, Failure, Loss of kidney function, End-stage renal disease (p-RIFLE) criteria.
  • To determine the clinical outcomes in children treated with colistimethate sodium.

Main Methods:

  • Prospective observational study conducted over two years.
  • Inclusion criteria: pediatric patients receiving colistin for >48 hours.
  • Monitoring for renal failure via p-RIFLE criteria and neurotoxicity.

Main Results:

  • A survival rate of 76.5% (52 out of 68 children) was observed.
  • Three children (4.4%) experienced acute kidney injury; no neurotoxicity was reported.
  • Serum creatinine levels significantly decreased post-treatment (P=0.007).

Conclusions:

  • Colistimethate sodium demonstrates efficacy in treating carbapenem-resistant Gram-negative bacterial infections in children.
  • The antibiotic is deemed safe for pediatric use, with manageable renal effects.
  • Colistimethate sodium offers a viable therapeutic option for severe pediatric infections.
Abstract

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