Colistin use in pediatric intensive care unit for severe nosocomial infections: experience of an university hospital


Karli A., Paksu M. S., Karadag A., BELET N., Paksu S., Guney A. K., ...Daha Fazla

ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS, cilt.12, 2013 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 12
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1186/1476-0711-12-32
  • Dergi Adı: ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Anahtar Kelimeler: Colistin, Child, Multi-drug resistant bacteria, Nosocomial infection, Nephrotoxicity
  • Dokuz Eylül Üniversitesi Adresli: Hayır

Özet

Background: The aim of this study was to investigate the efficacy and safety of colistin therapy in pediatric patients with severe nosocomial infections in pediatric intensive care unit. Methods: The medical records of patients treated with colistin at a 200-bed university children hospital were reviewed. Result: Thirty-one patients (male/female = 22/9; median age, 3 years; range, 3 months-17 years) received forty-one courses of colistin. The average dose of colistin was 4.9 +/- 0.5 mg/kg/day and average treatment duration was 19.8 +/- 10.3 days. Three patients who received concomitant nephrotoxic agent with colistin developed nephrotoxicity. Colistin treatment was well tolerated in other patients, and neurotoxicity was not seen in any patient. Favourable outcome was achieved in 28 (68.3%) episodes. Twelve patients died during the colistin therapy. Six of these patients died because of primary underlying disease. The infection-related mortality rate was found 14.6% in this study. Conclusion: In our study, colistin therapy was found to be acceptable treatment option for the severe pediatric nosocomial infections caused by multi-drug resistant bacteria. However, the use of concomitant nephrotoxic drugs with colistin must be avoided and renal function test should be closely monitored.