Colistin use in critically ill neonates: A case-control study.

Abstract:

BACKGROUND:The aim of this study was to assess the safety and efficacy of colistin use in critically ill neonates. METHODS:This was a case-control study that included newborn infants with proven or suspected nosocomial infections between January 2012 and October 2015, at two centers in Diyarbakir, Turkey. The clinical and laboratory characteristics and outcomes of patients who received colistin therapy were reviewed and compared to patients who were treated with antimicrobial agents other than colistin during the same period. RESULTS:Forty-seven cases who received intravenous colistin (colistin group) and 59 control patients (control group) were included. There were no significant differences between the groups regarding outcomes and nephrotoxicity, including acute renal failure. Colistin therapy was associated with significantly reduced serum magnesium (1.38 ± 0.39 mg/dL vs. 1.96 ± 0.39 mg/dL, p < 0.001) and hypokalemia (46.8% vs. 25.4%, p = 0.026). The patients who received colistin also had longer hospital stays (43 (32-70) days vs. 39 (28-55) days, p = 0.047), a higher rate of previous carbapenem exposure (40.4% vs. 11.9%, p = 0.001), and a higher age at the onset of infection (13 (10-21) days vs. 11 (9-15) days, p = 0.03). CONCLUSION:This study showed that colistin was both effective and safe for treating neonatal infections caused by multidrug-resistant gram-negative bacteria. However, intravenous colistin use was significantly associated with hypomagnesemia and hypokalemia.

journal_name

Pediatr Neonatol

authors

İpek MS,Aktar F,Okur N,Celik M,Ozbek E

doi

10.1016/j.pedneo.2016.10.002

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

490-496

issue

6

eissn

1875-9572

issn

2212-1692

pii

S1875-9572(17)30176-6

journal_volume

58

pub_type

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