Τίτλος:
Intravenous colistimethate (colistin) use in critically ill children without cystic fibrosis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Introduction: The increasing frequency of infections caused by multidrug-resistant (MDR) Gram-negative bacteria has led to the reappraisal of colistimethate use. Methods: We present a case series of critically ill pediatric patients without cystic fibrosis who received intravenous colistimethate treatment. All available relevant medical records were reviewed. Results: Seven children without cystic fibrosis (mean age 7.7 years; 2 female), admitted to the intensive care unit of a tertiary-care pediatric hospital in Athens, Greece, were identified to have received intravenous colistimethate during October 2004 to May 2008. MDR Acinetobacter baumannii, Pseudomonas aeruginosa, and/or Klebsiella pneumoniae were isolated from blood and/or bronchial secretions specimens in 6 of 7 reported patients. All isolates were susceptible to colistin. All 7 patients received intravenous colistimethate in a dosage of 5 mg/kg daily (divided in 3 equal doses, administered every 8 hours). Five children received colistimethate for 10 days and the remaining 2 for 2 and 23 days, respectively. The infections caused by MDR Gram-negative bacteria were improved in 6 children with microbiologically documented infections. Five of the 7 children were discharged from the ICU. The remaining 2 children died (1 of them had received colistimethate for 2 days); their death was not attributed to MDR Gram-negative infection. No nephrotoxicity or other type of toxicity of colistimethate was noted in this case-series. Conclusions: Although the small number of included cases precludes any firm conclusions, our study suggests that colistimethate may have a role for the treatment of infections caused by MDR Gram-negative bacteria in critically ill pediatric patients. © 2009 by Lippincott Williams & Wilkins.
Συγγραφείς:
Falagas, M.E.
Sideri, G.
Vouloumanou, E.K.
Papadatos, J.H.
Kafetzis, D.A.
Περιοδικό:
The Pediatric Infectious Disease Journal
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
amikacin; aminoglycoside antibiotic agent; amphotericin B lipid complex; ceftriaxone; cilastatin plus imipenem; ciprofloxacin; colistimethate; cotrimoxazole; dicloxacillin; gentamicin; metronidazole; piperacillin plus tazobactam; teicoplanin; vancomycin; antiinfective agent; colistin, Acinetobacter baumannii; adolescent; antibiotic sensitivity; article; bacterium isolate; child; clinical article; critically ill patient; cystic fibrosis; drug efficacy; drug safety; drug utilization; female; Gram negative infection; Greece; human; intensive care unit; Klebsiella pneumoniae; male; medical record; mortality; multidrug resistance; nephrotoxicity; neurotoxicity; priority journal; Pseudomonas aeruginosa; treatment outcome; critical illness; drug effect; Gram negative bacterium; Gram negative infection; infant; intravenous drug administration; newborn; preschool child, Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Colistin; Critical Illness; Cystic Fibrosis; Drug Resistance, Multiple, Bacterial; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Infant; Infant, Newborn; Injections, Intravenous; Male
DOI:
10.1097/INF.0b013e31818a5dbd
