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The Use of Colistin for the Treatment of Multidrug-resistant Gram-negative Infections in Neonates and Infants
- Source :
- Pediatric Infectious Disease Journal. 38:1107-1112
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- In this review, we report the available data regarding efficacy, safety and pharmacokinetics of colistin in the treatment of multidrug-resistant Gram-negative bacteria in neonates and infants. Seventeen clinical studies, involving 312 patients, and 3 pharmacokinetics studies were identified. Blood stream infection was the most common source of infection, followed by pneumonia and meningitis/ventriculitis. In most cases, colistin was administered in association with other antibiotics. The most common route of administration was intravenous, with colistimethate doses ranging from 25,000 to 225,000 IU/kg/day divided into 2 or 3 doses. A recent pharmacokinetic study suggested that the appropriate intravenous dose should be >150,000 IU/kg/day. Microbiologic cure was obtained in 94.2% of patients and survival was 76.6%. The combination of intraventricular and intravenous colistin should be used in meningitis/ventriculitis. Nebulized colistin should be used as adjunctive treatment, but not as monotherapy. Nephrotoxicity and apnea were reported in 5.8% and 3.9% of patients respectively.The use of colistin for multidrug-resistant Gram-negative infections in neonates and infants is effective and safe, but the quality of studies is moderate. The optimal intravenous dose should be higher than that indicated in most reports.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
medicine.drug_class
Antibiotics
03 medical and health sciences
Route of administration
0302 clinical medicine
Pharmacokinetics
Drug Resistance, Multiple, Bacterial
030225 pediatrics
Internal medicine
medicine
Ventriculitis
Humans
030212 general & internal medicine
Colistin
business.industry
Infant, Newborn
Infant
medicine.disease
Anti-Bacterial Agents
Treatment Outcome
Infectious Diseases
Pediatrics, Perinatology and Child Health
Adjunctive treatment
Administration, Intravenous
Gram-Negative Bacterial Infections
business
Meningitis
Colistimethate
medicine.drug
Subjects
Details
- ISSN :
- 08913668
- Volume :
- 38
- Database :
- OpenAIRE
- Journal :
- Pediatric Infectious Disease Journal
- Accession number :
- edsair.doi.dedup.....87d2e44854b90b3b4b891bd37c162e39