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Colistin use in neonates with multidrug-resistant Gram-negative infections: challenges in antimicrobial stewardship

Muhammad Shahid Mehmood1, Fatima Hajj2

  • 1Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad, Pakistan.

Annals of Medicine and Surgery (2012)
|December 11, 2025
PubMed

Insights

Colistin is crucial for treating multidrug-resistant infections in newborns, but its use is debated due to safety concerns and emerging resistance. Optimizing its application is vital for vulnerable infants.

Area of Science:

  • Neonatal intensive care
  • Infectious diseases
  • Pharmacology

Background:

  • Colistin is a vital last-resort antibiotic for multidrug-resistant (MDR) Gram-negative infections in neonatal intensive care units (NICUs).
  • MDR Gram-negative infections cause significant mortality and morbidity in neonates, often presenting as late-onset sepsis.
  • Colistin use in neonates is controversial due to limited pharmacokinetic data, toxicity risks (nephrotoxicity, neurotoxicity), and emerging resistance.

Keywords:
antimicrobial stewardshipcolistinmcr resistancemultidrug-resistant Gram-negative bacterianeonatal sepsisneonates

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