Abstract | INTRODUCTION: The increasing frequency of infections caused by multidrug-resistant (MDR) Gram-negative bacteria has led to the reappraisal of colistimethate use. METHODS: 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.
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Authors | Matthew E Falagas, Georgia Sideri, Evridiki K Vouloumanou, John H Papadatos, Dimitris A Kafetzis |
Journal | The Pediatric infectious disease journal
(Pediatr Infect Dis J)
Vol. 28
Issue 2
Pg. 123-7
(Feb 2009)
ISSN: 0891-3668 [Print] United States |
PMID | 19116601
(Publication Type: Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Colistin
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Topics |
- Adolescent
- Anti-Bacterial Agents
(therapeutic use)
- Child
- Child, Preschool
- Colistin
(administration & dosage, therapeutic use)
- Critical Illness
- Cystic Fibrosis
- Drug Resistance, Multiple, Bacterial
- Female
- Gram-Negative Bacteria
(drug effects)
- Gram-Negative Bacterial Infections
(drug therapy)
- Humans
- Infant
- Infant, Newborn
- Injections, Intravenous
- Male
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