Old agent, new experience: colistin use in the paediatric Intensive Care Unit—a multicentre study

The Use of Colistin in Critically Ill Children in a Pediatric Intensive Care Unit

“…2,6 There is limited information about systemic colistin use in pediatric patients. [7][8][9] For this reason, a prospective observational study was planned to evaluate the efficacy and safety of colistin used to treat multidrug-resistant microorganisms in pediatric intensive care unit settings.…”

Pharmacokinetics of Colistin Methanesulfonate and Formed Colistin in End-Stage Renal Disease Patients Receiving Continuous Ambulatory Peritoneal Dialysis

“…This situation has led to a resurgence in the use of colistin in many health care centers around the world (1,6). Within the last decade, a number of clinical studies have shown favorable outcomes of CMS/colistin treatment (7)(8)(9)(10). Our recent study showed that patients infected with MDR A. baumannii and P. aeruginosa who received parenteral CMS had more favorable clinical response (80.8% versus 26.7%) and lower overall mortality (46.2% versus 80.0%) than those who were not treated with CMS/colistin (11).…”

Intravenous polymyxins: Revival with puzzle

“…A recently published 10-year case series indicated that CMS use increased, more than half of the patients were discharged alive, and no significant nephrotoxicity was observed in the 5603 patients prescribed CMS (along with other antibiotics) (18). It's reported that colistin based treatment in different kinds of infections due to GNB has a clinical response rate of 43.1-79% (19)(20)(21)(22), and microbiological response rate of 66.7% (34/51) (19). Intravenous polymyxins therapy can be used either as monotherapy or in combination with other antibiotics.…”

“…intravenous polymyxins alone in MDR GNB infections, most of which were pneumonias. It's indicated that the mortality ranged from 0% to 74.3% (4,21,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37), clinical response (cure and improvement) rate 7-82.1%, and microbiological eradication 27.3-73.9% (24,(33)(34)(35)(36)(37)(38). In respect to the colistin only susceptible strains, it's reported that the mortality in hospitals of intravenous colistin monotherapy was 50% (16/32) (Figure 2), 11 patients died in Intensive Care Unit (ICU) (39), and clinical cure was obtained in 82.1% of infectious episodes (23/28) and bacteriological clearance was achieved in 73.9% (17/23) of the cured infectious episodes (38).…”

“…Some case reports indicated that intravenous colistin was effective and tolerable in children infected by A. baumannii (99,(101)(102)(103). It's has been reported in several trials that colistin is effective in the treatment of severe nosocomial infections caused by MDR Gramnegative bacteria and is generally well tolerated in pediatric patients, even after relatively long-term use (21,22). A similar result was found in a case series of 8 meningitis patients due to multidrug-resistant and pan-resistant Acinetobacter spp, with a regimen of IV polymyxin plus intrathecal polymyxin.…”