colistin and Infant--Newborn--Diseases

Topics: Ampicillin; Anti-Bacterial Agents; Bicarbonates; Body Temperature; Buffers; Colistin; Female; Humans; Incubators; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Male; Methicillin; Oxygen Consumption; Oxygen Inhalation Therapy; Parenteral Nutrition; Peritoneal Dialysis; Polymyxins; Positive-Pressure Respiration; Respiration, Artificial; Respiratory Distress Syndrome, Newborn; Tromethamine

Topics: Anti-Bacterial Agents; Cephalosporins; Chloramphenicol; Colistin; Drug Hypersensitivity; Erythromycin; Gentamicins; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Infections; Intestinal Absorption; Kanamycin; Neomycin; Odontogenesis; Oleandomycin; Penicillin Resistance; Penicillins; Polymyxins; Staphylococcal Infections; Streptomycin; Tetracycline

Colistin is an antibiotic in the polymyxin group and is especially important in the elimination of multi-drug resistant gram negative bacteria. To date, there are many studies investigating colistin related side effects, especially nephrotoxicity. However, there are few studies involving premature neonates, and this study aimed to investigate the side effects of colistin in this particular patient group.. Between January 2016 and May 2019, the medical records of premature neonates treated with colistin were retrospectively reviewed. The diagnosis of acute kidney injury (AKI) was performed according to the modified neonatal KDIGO criteria. Serum electrolyte levels were recorded at the initiation of colistin treatment and 4-7 days after.. A total of 47 premature neonates; with a median gestational age of 27 weeks and median weight of 970 g at birth were included in the study. The median postnatal day of colistin initiation was 24 days and mean duration of colistin therapy was 15.95 ± 3.70 days. Colistin was combined with aminoglycosides in 44.6% of the patients. Acute kidney injury was documented in 17.0% of premature neonates. (n = 6 for stage 1, n = 2 for stage 2, none of the patients had stage 3). In univariate analysis, gestational age and concomitant aminoglycoside use were associated with AKI development (OR, 0.446; 95% CI 0.238-0.832; p = 0.011 and OR, 1.324; 95% CI 1.023- 7.584; p = 0.024). Mean magnesium level significantly decreased after colistin treatment (1.70 ± 0.84 vs. 1.57 ± 0.29, p = 0.017) and the frequency of hypomagnesemia increased after colistin use (78.7% vs. 91.5%, p = 0.031). Frequency of elevated AST increased from 23.4% to 44.7% following colistin use (p = 0.031).. Colistin-related side effects observed in premature neonates are not as common as in pediatric patients. Electrolyte imbalance is observed more frequently in this age group following colistin use. We suggest strict serum electrolyte level monitoring, especially magnesium, in premature neonates that are receiving colistin.

Topics: Anti-Bacterial Agents; Child; Colistin; Drug Resistance, Multiple, Bacterial; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Retrospective Studies

Neonatal sepsis caused by multidrug-resistant gram-negative bacteria has been reported in different parts of the world. It is a major threat to neonatal care, carrying a high rate of morbidity and mortality. While Colistin is the treatment of choice, few studies have reported its use in neonatal patients.. A retrospective descriptive study of all neonatal patients who had multidrug-resistant Acinetobacter sepsis and were treated with Colistin over a 2-year period. Patients' charts and hospital laboratory data were reviewed.. During the study period, 21 newborns were treated with Colistin. All had sepsis evident by positive blood culture and clinical signs of sepsis. The median gestational age and birth weight were 33 weeks (26-39) and 1700 g (700-3600), respectively. Nine (43 %) were very low birth weight infants. Eighteen (86 %) were preterm infants. Nineteen (91 %) newborns survived. No renal impairment is documented in any of our patients. Fourteen (67 %) of our patients had elevated eosinophil counts following Colistin treatment, for those patients, the average eosinophilic counts ± standard deviation before and after Colistin therapy were 149.08 ± 190.38 to 1193 ± 523.29, respectively, with a p value of less than 0.0001.. Our study showed that Colistin was both effective and safe for treating multidrug-resistant Acinetobacter neonatal sepsis. This is a retrospective study. No universal protocol was used for the patients. The factors that might affect the response or cause side effects are difficult to evaluate.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Administration, Intravenous; Anti-Bacterial Agents; Colistin; Drug Resistance, Multiple, Bacterial; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Sepsis

In this study, we sought to evaluate the pharmacokinetics of colistin after intravenous administration of colistimethate sodium (CMS) in the critically ill neonates with Gram-negative bacterial infections. A single intravenous dose of CMS [approximately 150,000 IU/kg, equivalent to 5 mg/kg colistin base activity (CBA)] was administered to 7 critically ill neonates. Mean (±SD) maximum plasma colistin concentration and area under the time-concentration curve from 0 to infinity were 3.0 ± 0.7 µg/mL and 25.3 ± 10.4 µg·h/mL, respectively. Time to maximum concentration, half-life, apparent volume of distribution and clearance were 1.3 ± 0.9 hours, 9.0 ± 6.5 hours, 7.7 ± 9.3 L/kg and 0.6 ± 0.3 L/h/kg, respectively. After a dose regimen of 5 mg/kg CBA every 24 hours, the average concentration expected at steady state is 1.1 ± 0.4 µg/mL. In critically ill neonates, a single intravenous dose of 5 mg CBA/kg (approximately 150,000 IU/kg of CMS) resulted in suboptimal plasma concentrations of colistin. According to our pharmacokinetics data, the dosage of CMS currently used in critically ill neonates is insufficient.

Topics: Administration, Intravenous; Anti-Bacterial Agents; Bacteremia; Colistin; Critical Illness; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Pneumonia, Bacterial; Prospective Studies

Topics: Anti-Bacterial Agents; Colistin; Enterobacteriaceae Infections; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestines; Klebsiella; Sepsis; Serotyping

The effects of orally administered gentamicin and colistin on stool bacterial flora and overall antibiotic sensitivity patterns were evaluated in 100 newborns at risk for neonatal necrotizing enterocolitis. Gentamicin (2.5 mg/kg q6h) and colistin (1 mg/kg q6h) were administered to randomly selected groups of 50 newborns for 3 wk after birth during an 11-month study period. Stools were collected on days 1, 11, and 21 and cultures were grown under aerobic conditions on three different media. Staph. epidermidis was the most common predominant organism in both antibiotic groups, whereas E. coli and Klebsiella were the most common Gram-negative bacteria isolated. Seventeen % of these Gram-negative species were resistant to colistin and 9% to gentamicin, with a gradual increase occurring during the 3-wk period. On the basis of 980 positive cultures from all sites in babies in the nursery during the 11-month study, E. coli sensitivity to kanamycin and gentamicin ranged between 92% and 100% except for one month midway through the study when sensitivity to kanamycin was at 80% and then returned to the 92-100% range. Klebsiella sensitivity to both aminoglycosides remained greater than 95% throughout. The incidence of neonatal sepsis remained consistent at seven to nine per 1000 live births during the study. One baby of 50 in the gentamicin group developed necrotizing enterocolitis at 5 wk of age; 0/50 in the colistin group had necrotizing enterocolitis (not significant).

Topics: Colistin; Drug Resistance, Microbial; Enterocolitis, Pseudomembranous; Escherichia coli; Feces; Gentamicins; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Klebsiella; Risk; Staphylococcus

The chemotherapy of septicaemia in newborns differs fundamentally from that in older children or adults because, although newborns have a fully developed immunological system, the system has not yet "learned" to operate completely. Ultimately, optimal chemotherapy can only be found empirically. In this respect a few basic guidelines can be given however: 1. The initial therapy must bring the pathogen under control with a high degree of certainty, since a correction in therapy following pathogen indentification is usually too late. 2. Since the pharmacokinetics of antibiotics in newborns vary considerably, the minimal peak serum concentration observed should exceed the MIC of the pathogen. 3. In rapidly maturing newborns and premature babies the pharmacokinetics of each antibiotic must be known precisely. 4. Since in the individual case there can never be absolute certainty with respect to the three above-mentioned problems, combination therapy should be given at all times.

Topics: Amikacin; Anti-Bacterial Agents; Cefuroxime; Colistin; Dose-Response Relationship, Drug; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Kinetics; Meningitis; Sepsis; Tobramycin

The effect of antibiotic therapy on the intestinal flora was studied qualitatively and quantitatively in 41 infants. The results have been compared with 27 normal children of the same age and background. Antibiotics were responsible for the suppression of sensitive strains and for their replacement by resistant organisms but above all to a rapid multiplication of the intestinal flora. Colistin and pristinamycin caused these changes when given orally. Ampicillin when given both orally and parenterally but Colistin and the aminoglycosides when given parenterally did not have any effect. Fourteen cases of secondary septicaemia due to resistant organisms were observed but other factors were also important, namely the young age of the patients and intestinal problems (stasis and diarrhoea).

Topics: Age Factors; Ampicillin; Anti-Bacterial Agents; Bacterial Infections; Child; Child, Preschool; Colistin; Feces; Follow-Up Studies; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Diseases; Intestines; Klebsiella Infections; Penicillin Resistance; Proteus Infections; Sepsis; Staphylococcal Infections

An epidemic caused by Serratia marcescens occurred in intensive care unit of the Children's clinic in Essen, with three deaths. Although there was good sensitivity of the strain to gentamicin in vitro, there was no noticeable clinical improvement when it was administered. But cotrimoxazole, given systemically and locally, and colistin locally cured the disease.

Topics: Colistin; Cross Infection; Disease Outbreaks; Enterobacteriaceae Infections; Gentamicins; Germany, West; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intensive Care Units; Sepsis; Serratia marcescens; Sulfamethoxazole; Trimethoprim

The current circumstances associated with Pseudomonas aeruginosa bacteremia are reviewed in 108 episodes to assess the impact of new antimicrobial drugs on this infection. Since 1961, Pseudomonas bacteremia has apparently become more frequent with proportional increases in middle-aged patients. The respiratory tract has become the major source of infection. Clinical features are not characteristic, but infected patients are almost uniformly severely ill before blood stream invasion occurs. The use of gentamicin, carbenicillin and colistin has not changed the outcome of Pseudomonas bacteremia. Although better than no antimicrobial treatment, these drugs cannot be shown to be superior to any other available antibiotics. A reassessment is needed to evaluate the relationship between the in vitro action and the effectiveness of antibiotics in the treatment of Pseudomonas infection and the use of gentamicin, carbenicillin and colistin in these bacteremias. In view of the poor results with antibiotics, investigation into immunologic prophylaxis and therapy is needed. At the present time, control of the patients' underlying disease contributes most towards assuring survival with Pseudomonas bacteremia.

Topics: Anti-Bacterial Agents; Carbenicillin; Chronic Disease; Colistin; Cross Infection; Gentamicins; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Neoplasms; Penicillin Resistance; Pseudomonas aeruginosa; Pseudomonas Infections; Sepsis

Topics: Amino Acids; Ampicillin; Chloramphenicol; Colistin; Dysentery, Bacillary; Electrolytes; Gentamicins; Glucose; Humans; Infant Food; Infant, Newborn; Infant, Newborn, Diseases; Infusions, Parenteral; Male; Neomycin; Oligosaccharides; Osmolar Concentration; Shigella flexneri; Vitamins

Topics: Ampicillin; Anti-Bacterial Agents; Carbenicillin; Cephalothin; Chloramphenicol; Colistin; Dicloxacillin; Escherichia coli Infections; Gentamicins; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Pseudomonas Infections; Sepsis; Staphylococcal Infections; Streptococcal Infections

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: Ampicillin; Animals; Carbenicillin; Colistin; Female; Gentamicins; Germany, West; Gestational Age; Hemiplegia; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Male; Meningitis; Oxacillin; Pregnancy; Prognosis; Spinal Puncture

Topics: Colistin; Femur; gamma-Globulins; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Osteomyelitis; Pseudomonas Infections; Streptomycin

Topics: Ampicillin; Anti-Bacterial Agents; Cephaloridine; Colistin; Enterobacteriaceae; Escherichia coli; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infections; Kanamycin; Klebsiella; Microbial Sensitivity Tests; Proteus

Topics: Ampicillin; Child, Preschool; Colistin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Oxacillin; Pneumonia, Aspiration

Topics: Antibodies; Colistin; Escherichia coli; Escherichia coli Infections; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases

Topics: Amphotericin B; Bronchopneumonia; Candidiasis; Child; Colistin; Female; Humans; Iatrogenic Disease; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infusions, Parenteral; Male; Meningitis; Sepsis; Sterilization; Vaccination

Topics: Chloramphenicol; Colistin; Cross Infection; Disease Outbreaks; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Paris; Salmonella Infections

Topics: Animals; Brain; Chloramphenicol; Colistin; Electrocardiography; Enterobacteriaceae; Enterobacteriaceae Infections; Female; Fever; Humans; Infant, Newborn; Infant, Newborn, Diseases; Leukocyte Count; Meningitis; Penicillins; Sepsis; Snakes; Spinal Puncture; Streptomycin; Sulfadiazine

Topics: Ampicillin; Colistin; Communicable Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meningitis; Oxacillin; Pneumonia; Pseudomonas Infections; Pyoderma; Sepsis

Topics: Anti-Bacterial Agents; Child; Chloramphenicol; Colistin; Diazepam; Heparin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meningitis; Penicillins; Pneumonia, Staphylococcal; Prednisone; Sepsis; Sulfonamides

Topics: Anti-Bacterial Agents; Calcinosis; Calcium; Candida; Colistin; Diagnosis, Differential; Female; gamma-Globulins; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lung Diseases; Lung Diseases, Fungal; Phosphorus; Radiography, Thoracic; Trachea; Tuberculosis, Pulmonary

Topics: Alcaligenes; Cephaloridine; Colistin; Drug Resistance, Microbial; Enterobacter; Escherichia coli; Humans; Infant, Newborn; Infant, Newborn, Diseases; Kanamycin; Klebsiella; Polymyxins; Proteus; Pseudomonas

Topics: Bronchopneumonia; Cephaloridine; Colistin; Enteritis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infections; Kanamycin; Methicillin; Polymyxins

Topics: Colistin; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meningitis; Pseudomonas aeruginosa; Pseudomonas Infections

Topics: Bacitracin; Child; Colistin; Drug Therapy; Endocarditis; Endocarditis, Bacterial; Enterobacter aerogenes; Escherichia coli Infections; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infections; Klebsiella; Liver Abscess; Oxacillin; Penicillins; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections; Toxicology

Topics: Anti-Bacterial Agents; Bacitracin; Chloramphenicol; Colistin; Drug Therapy; Erythromycin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Kanamycin; Neomycin; Novobiocin; Penicillins; Polymyxins; Streptomycin; Tetracycline

Topics: Animals, Newborn; Colistin; Dogs; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Kidney Diseases; Mesylates; Methane; Pseudomonas Infections; Research; Toxicology; Urea

Topics: Colistin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases

Topics: Anti-Bacterial Agents; Colistin; Humans; Hydrocortisone; Infant, Newborn; Infant, Newborn, Diseases; Listeria; Meningitis; Meningitis, Listeria; Methicillin; Oxytetracycline; Penicillins; Streptomycin; Sulfisoxazole

Topics: Anti-Bacterial Agents; Chloramphenicol; Clioquinol; Colistin; Drug Resistance, Microbial; Enteritis; Erythromycin; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Neomycin; Nitrofurantoin; Oleandomycin; Oxytetracycline; Penicillin Resistance; Phenanthrolines; Proteus Infections; Quinones; Rolitetracycline; Streptomycin; Sulfisomidine; Tetracycline

Topics: Anti-Bacterial Agents; Child; Colistin; Enteritis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases