Nov 8, 2018

Intravenous colistin use for infections due to multidrug-resistant gram-negative bacilli in critically ill paediatric patients: a systematic review and meta-analysis

BioRxiv : the Preprint Server for Biology
Spyridon A KarageorgosConstantinos Tsioutis

Abstract

Background: Data are limited regarding the clinical effectiveness and safety of intravenous colistin for treatment of infections by multidrug-resistant gram-negative bacilli (MDR-GNB) in the paediatric intensive care unit (PICU). Methods: Systematic review of intravenous colistin use in critically ill paediatric patients with MDR-GNB infection in PubMed, Scopus and Embase (through January 31st, 2018). Results: Out of 1,181 citations, 7 studies were included on the use of intravenous colistin for 405 patients in PICU. Majority of patients were diagnosed with lower respiratory tract infections, with Acinetobacter baumannii being the predominant pathogen. Colistin dosages ranged between 2.6-18 mg/kg/day, with none but one case reporting a loading dose. Emergence of colistin-resistance during treatment was reported in two cases. Nephrotoxicity and neurotoxicity were reported in 6.1% and 0.5% respectively, but concomitant medications and severe underlying illness limited our ability to definitively associate use of colistin with nephrotoxicity. Crude mortality was 29.5% (95%CI 21.7-38.1%), whereas infection-related mortality was 16.6% (95%CI 12.2-21.5%). Conclusions: While the reported incidence of adverse events related to colistin...Continue Reading

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Mentioned in this Paper

Study
Acinetobacter calcoaceticus
Pediatric Intensive Care Unit
Meta-Analysis (Publications)
Nephrotoxicity
Meta Analysis (Statistical Procedure)
Pathogenic Organism
Colistin
Pediatric Discipline
Adverse Event

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