Pediatrics & Neonatology

Pediatrics & Neonatology

Volume 58, Issue 6, December 2017, Pages 490-496
Pediatrics & Neonatology

Original Article
Colistin use in critically ill neonates: A case–control study

https://doi.org/10.1016/j.pedneo.2016.10.002Get rights and content
Under a Creative Commons license
open access

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.

Key Words

colistin
neonate
nosocomial infection
multi-drug resistant
gram-negative bacteria

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