colistin and Birth-Weight

Infections caused by extensive drug-resistant Acinetobacter baumannii (XDR-AB) have been increasingly observed and are associated with a high mortality rate. We present our experience using aerosolized colistin for the treatment of ventilator-associated pneumonia (VAP) due to XDR-AB in neonates.. The clinical data of neonates who received aerosolized 4 mg per kg of colistin base twice daily as an adjunctive therapy for VAP caused by XDR-AB between July 2008 and September 2009 were retrospectively reviewed. The outcomes were compared with the neonates with VAP from XDR-AB in October 2006-September 2007 who did not receive aerosolized colistin.. During the study period, eight neonates (three preterm and five term neonates) with VAP caused by XDR-AB received aerosolized colistin. All isolated pathogens from the tracheobronchial specimens of the eight patients were XDR-AB susceptible to colistin only. Six patients received aerosolized colistin without concomitant intravenous colistin. All children were cured with eradication of XDR-AB from respiratory secretions. Seven patients survived and were discharged from the hospital, and one died from bacterial sepsis unrelated to the VAP episode. There were no clinical or laboratory adverse events related to aerosolized colistin. Compared to the seven neonates in the earlier period, the neonates who received aerosolized colistin had higher birth weight and gestational age, and lower mortality rate (13% vs. 71%, P=0.04).. Aerosolized colistin may be a useful adjunctive therapy in VAP due to XDR-AB. The use of aerosolized colistin in neonates should be investigated in a larger controlled study.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Administration, Inhalation; Aerosols; Anti-Bacterial Agents; Bacteremia; Birth Weight; Colistin; Drug Resistance, Bacterial; Female; Gestational Age; Humans; Infant, Newborn; Male; Pneumonia, Ventilator-Associated; Retrospective Studies; Thailand; Treatment Outcome

Topics: Birth Weight; Carbenicillin; Catheterization; Cephalothin; Colistin; Gentamicins; Humans; Infant, Newborn; Oxacillin; Sepsis; Time Factors; Umbilical Arteries; Umbilical Veins

Topics: Amniotic Fluid; Ampicillin; Birth Weight; Colistin; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Male; Mediastinal Emphysema; Oxacillin; Pneumothorax; Polymyxins; Radiography; Respiration, Artificial; Sex Factors; Time Factors

Topics: Birth Weight; Blood Pressure; Blood Transfusion; Carbonates; Colistin; Female; gamma-Globulins; Gestational Age; Glucose; Heart Rate; Humans; Infant Care; Infant Mortality; Infant, Newborn; Infant, Premature; Infusions, Parenteral; Male; Methicillin; Milk, Human; Penicillins; Plasma; Respiration; Respiratory Distress Syndrome, Newborn; Sodium

Topics: Bilirubin; Birth Weight; Blood; Blood Urea Nitrogen; Calcium; Carbon Dioxide; Carbonates; Colistin; Electrocardiography; Female; gamma-Globulins; Glucose; Humans; Hydrogen-Ion Concentration; Hyperbilirubinemia; Hypocalcemia; Infant Care; Infant, Newborn; Infant, Premature; Infusions, Parenteral; Male; Methicillin; Milk, Human; Penicillins; Phosphorus; Plasma; Potassium; Sodium

Topics: Age Factors; Aminopyrine; Ampicillin; Anti-Bacterial Agents; Benzopyrenes; Birth Weight; Colistin; Cytochromes; Electron Transport; Female; Gestational Age; Half-Life; Humans; Hydroxylation; Infant, Newborn; Infant, Premature; Injections, Intramuscular; Oxidoreductases; Pregnancy; Spectrophotometry; Testosterone