Colistin use in critically ill neonates: AÂ caseâcontrol study
Background: The aim of this study was to assess the safety and efficacy of colistin use in critically ill neonates. Methods: This was a caseâcontrol study that included newborn infants with proven or suspected nosocomial infections between January 2012 and October 2015, at two centers in Diyarbakir,...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-12-01
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| Series: | Pediatrics and Neonatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957217301766 |
| _version_ | 1811263914052157440 |
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| author | Mehmet Sah Ä°pek Fesih Aktar Nilufer Okur Muhittin Celik Erdal Ozbek |
| author_facet | Mehmet Sah Ä°pek Fesih Aktar Nilufer Okur Muhittin Celik Erdal Ozbek |
| author_sort | Mehmet Sah Ä°pek |
| collection | DOAJ |
| description | Background: The aim of this study was to assess the safety and efficacy of colistin use in critically ill neonates. Methods: This was a caseâcontrol 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 (32â70) days vs. 39 (28â55) 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 (10â21) days vs. 11 (9â15) 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. Key Words: colistin, neonate, nosocomial infection, multi-drug resistant, gram-negative bacteria |
| first_indexed | 2024-04-12T19:53:41Z |
| format | Article |
| id | doaj.art-cfc07cf740c74aac92b452c16fc6f65f |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-04-12T19:53:41Z |
| publishDate | 2017-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-cfc07cf740c74aac92b452c16fc6f65f2022-12-22T03:18:43ZengElsevierPediatrics and Neonatology1875-95722017-12-01586490496Colistin use in critically ill neonates: A caseâcontrol studyMehmet Sah Ä°pek0Fesih Aktar1Nilufer Okur2Muhittin Celik3Erdal Ozbek4Division of Neonatology, Department of Pediatrics, Memorial Dicle Hospital, Diyarbakir, Turkey; Corresponding author. Memorial Dicle Hospital, Urfa Road 3rd km, No: 150, Kayapinar, Diyarbakir, Turkey. Fax: +90 4123156615.Department of Pediatrics, Dicle University Faculty of Medicine, Diyarbakir, TurkeyDepartment of Pediatrics, Maternity and Children's Hospital, Diyarbakir, TurkeyDivision of Neonatology, Department of Pediatrics, Diyarbakir Children's Hospital, Diyarbakir, TurkeyDepartment of Microbiology, Maternity and Children's Hospital, Diyarbakir, TurkeyBackground: The aim of this study was to assess the safety and efficacy of colistin use in critically ill neonates. Methods: This was a caseâcontrol 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 (32â70) days vs. 39 (28â55) 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 (10â21) days vs. 11 (9â15) 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. Key Words: colistin, neonate, nosocomial infection, multi-drug resistant, gram-negative bacteriahttp://www.sciencedirect.com/science/article/pii/S1875957217301766 |
| spellingShingle | Mehmet Sah Ä°pek Fesih Aktar Nilufer Okur Muhittin Celik Erdal Ozbek Colistin use in critically ill neonates: AÂ caseâcontrol study Pediatrics and Neonatology |
| title | Colistin use in critically ill neonates: AÂ caseâcontrol study |
| title_full | Colistin use in critically ill neonates: AÂ caseâcontrol study |
| title_fullStr | Colistin use in critically ill neonates: AÂ caseâcontrol study |
| title_full_unstemmed | Colistin use in critically ill neonates: AÂ caseâcontrol study |
| title_short | Colistin use in critically ill neonates: AÂ caseâcontrol study |
| title_sort | colistin use in critically ill neonates aa caseacontrol study |
| url | http://www.sciencedirect.com/science/article/pii/S1875957217301766 |
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