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Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity

OBJECTIVES: Colistin has come to the fore as a treatment option, especially with the occurrence of multidrug-resistant Gram-negative infections across the world. However, the high nephrotoxic effects of colistin should be taken into consideration in children. The study’s primary outcome was to deter...

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Autores principales: Ustundag, Gulnihan, Oncel, Eda Karadag, Sahin, Aslihan, Keles, Yildiz Ekemen, Aksay, Ahu Kara, Ciftdogan, Dilek Yilmaz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Med Bull Sisli Etfal Hosp 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580973/
https://www.ncbi.nlm.nih.gov/pubmed/36304221
http://dx.doi.org/10.14744/SEMB.2021.69851
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author Ustundag, Gulnihan
Oncel, Eda Karadag
Sahin, Aslihan
Keles, Yildiz Ekemen
Aksay, Ahu Kara
Ciftdogan, Dilek Yilmaz
author_facet Ustundag, Gulnihan
Oncel, Eda Karadag
Sahin, Aslihan
Keles, Yildiz Ekemen
Aksay, Ahu Kara
Ciftdogan, Dilek Yilmaz
author_sort Ustundag, Gulnihan
collection PubMed
description OBJECTIVES: Colistin has come to the fore as a treatment option, especially with the occurrence of multidrug-resistant Gram-negative infections across the world. However, the high nephrotoxic effects of colistin should be taken into consideration in children. The study’s primary outcome was to determine the clinical success of the colistin treatment, and the secondary outcome was to detect the side effects related to colistin. METHODS: The patients who received intravenous colistin in our hospital’s last 5 years were included in the study. In addition to the patients’ demographic and clinical characteristics, the clinical success of the colistin treatment, 28-day infection-related mortality of the patients, and side effects of colistin were recorded. RESULTS: A total of 37 patients received colistin therapy during 2015–2019. Four of these patients had colistin treatment twice a year, so we accepted them as separate cases in each infection attack. Therefore, 41 cases were included in the study. The median age of the cases was 26 months (IQR: 4.50–144.50) and 27 (65.9%) were male. Twenty-seven cases (65.9%) had sepsis. The median dose of colistin was 4.2 (IQR: 3–5) mg/kg/day. Among 44 cultures obtained from the patients, the most common microorganism was Acinetobacter baumannii, with 58.5%. The clinical success was detected in 18 patients (43.9%). While overall nephrotoxicity developed in 14 (34.1%) patients, only two of them needed dialysis. CONCLUSION: Colistin should not be considered the first choice in treating Gram-negative infections but should be kept as salvage therapy in multidrug-resistant Gram-negative infections across the world. During the treatment process, close monitoring of renal function tests and urinary output were recommended due to the risk of developing nephrotoxicity.
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spelling pubmed-95809732022-10-26 Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity Ustundag, Gulnihan Oncel, Eda Karadag Sahin, Aslihan Keles, Yildiz Ekemen Aksay, Ahu Kara Ciftdogan, Dilek Yilmaz Sisli Etfal Hastan Tip Bul Original Research OBJECTIVES: Colistin has come to the fore as a treatment option, especially with the occurrence of multidrug-resistant Gram-negative infections across the world. However, the high nephrotoxic effects of colistin should be taken into consideration in children. The study’s primary outcome was to determine the clinical success of the colistin treatment, and the secondary outcome was to detect the side effects related to colistin. METHODS: The patients who received intravenous colistin in our hospital’s last 5 years were included in the study. In addition to the patients’ demographic and clinical characteristics, the clinical success of the colistin treatment, 28-day infection-related mortality of the patients, and side effects of colistin were recorded. RESULTS: A total of 37 patients received colistin therapy during 2015–2019. Four of these patients had colistin treatment twice a year, so we accepted them as separate cases in each infection attack. Therefore, 41 cases were included in the study. The median age of the cases was 26 months (IQR: 4.50–144.50) and 27 (65.9%) were male. Twenty-seven cases (65.9%) had sepsis. The median dose of colistin was 4.2 (IQR: 3–5) mg/kg/day. Among 44 cultures obtained from the patients, the most common microorganism was Acinetobacter baumannii, with 58.5%. The clinical success was detected in 18 patients (43.9%). While overall nephrotoxicity developed in 14 (34.1%) patients, only two of them needed dialysis. CONCLUSION: Colistin should not be considered the first choice in treating Gram-negative infections but should be kept as salvage therapy in multidrug-resistant Gram-negative infections across the world. During the treatment process, close monitoring of renal function tests and urinary output were recommended due to the risk of developing nephrotoxicity. Med Bull Sisli Etfal Hosp 2022-09-22 /pmc/articles/PMC9580973/ /pubmed/36304221 http://dx.doi.org/10.14744/SEMB.2021.69851 Text en © Copyright 2022 by The Medical Bulletin of Sisli Etfal Hospital https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Original Research
Ustundag, Gulnihan
Oncel, Eda Karadag
Sahin, Aslihan
Keles, Yildiz Ekemen
Aksay, Ahu Kara
Ciftdogan, Dilek Yilmaz
Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity
title Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity
title_full Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity
title_fullStr Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity
title_full_unstemmed Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity
title_short Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity
title_sort colistin treatment for multidrug-resistant gram-negative infections in children: caution required for nephrotoxicity
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580973/
https://www.ncbi.nlm.nih.gov/pubmed/36304221
http://dx.doi.org/10.14744/SEMB.2021.69851
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