Investigation of Colistin Utilization in the Treatment of Multidrug-Resistant Gram-Negative Nosocomial Bloodstream Infections in Children and Literature Review

Abstract

Abstract Objective: This retrospective study aimed to assess the effectiveness and safety of combined colistin therapy in treating nosocomial infections caused by multi-drug resistant gram-negative pathogens in pediatric patients. Materials and Methods: 45 pediatric patients who received intravenous colistin for healthcare-associated infections at Dr. Sami Ulus Training and Research Hospital between January 2015 to 2020 were included. Patient-specific detailed clinical information, prognoses, and laboratory findings on days 1, 3, and 7 of colistin treatment were obtained from medical records Results: Among the patients, 26 [57.8%] were male and 19 [42.2%] were female, with a median age of 18 months. Clinical and microbiological responses were observed in 37 patients [82.2%], while two patients [4.4%] discontinued colistin due to side effects without assessing treatment response. Six patients [13.3%] did not achieve clinical and microbiological response and succumbed to the infection. Nephrotoxicity was the most common side effect, occurring in eight patients on the third day of treatment. One patient with nephrotoxicity had underlying chronic renal failure. Conclusion: Combined colistin therapy is effective and safe for treating nosocomial infections caused by multi-drug resistant gram-negative bacteria in pediatric patients, which often have high mortality rates and limited treatment options.