Efficacy and safety of intravenous colistin in preterm infants with nosocomial sepsis caused by Acinetobacter baumannii.

Abstract

OBJECTIVES:

To describe the efficacy of intravenous colistin on clinical and microbiological outcomes in preterm infants with nosocomial sepsis in neonatal intensive care unit (NICU) and define adverse events observed with this treatment.

METHODS:

The records of preterm infants who received colistin with or without positive cultures in the NICU were retrospectively reviewed. Patients were evaluated for response to therapy and side effects.

RESULTS:

A total of 21 preterm infants with medians of 28 weeks (23-36) gestational age and 870 g (620-2,650) birth weight were included. The median duration and dose of colistin therapy were 9 days (3-26) and 3 mg/kg/d (2-5). Recovery rate in patients including all with/without positive culture was 81% (17/21). Microbiological clearance by colistin was 69% (9/13). The major side effect observed was acute kidney injury (19%). At least 24% of infants required electrolyte supplementation during the colistin therapy. Magnesium levels were significantly lower at the end of the colistin therapy (p < 0.001). Acute kidney injury and electrolyte disturbances including hypomagnesemia were reversible in all surviving patients.

CONCLUSION:

We suggest that renal function tests and serum electrolytes should be monitored closely and replaced in case of any need during the colistin therapy in preterm infants.

• Authors: Serdar Alan, Duran Yildiz, Omer Erdeve, Ufuk Cakir, Dilek Kahvecioglu, Emel Okulu, Can Ates, Begum Atasay, Saadet Arsan
• Journal: American journal of perinatology (Am J Perinatol) Vol. 31 Issue 12 Pg. 1079-86 (Dec 2014) ISSN: 1098-8785 [Electronic] United States
• PMID: 24584997 (Publication Type: Journal Article)
• Copyright: Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Chemical References

• Anti-Bacterial Agents
• Electrolytes
• Magnesium
• Colistin

Topics

• Acinetobacter Infections (drug therapy)
• Acinetobacter baumannii
• Acute Kidney Injury (chemically induced)
• Administration, Intravenous
• Anti-Bacterial Agents (adverse effects, therapeutic use)
• Colistin (adverse effects, therapeutic use)
• Cross Infection (drug therapy)
• Electrolytes (therapeutic use)
• Female
• Humans
• Infant, Newborn
• Infant, Premature
• Infant, Premature, Diseases (drug therapy)
• Intensive Care, Neonatal
• Magnesium (blood)
• Male
• Microbial Sensitivity Tests
• Retrospective Studies
• Sepsis (drug therapy)
• Water-Electrolyte Imbalance (blood, chemically induced, drug therapy)