Colistin treatment in pediatric patients with

ICU-acquired infections caused by

multidrug-resistant Gram-negative bacteria

Ji-Hye Park°, Mi-Young Moon, Jae-Youn Kim, Young-Cheon Song

Department of Pharmacy, Asan Medical Center

The increasing incidence of infections caused by multidrug-resistant Gram-negative bacteria is a worldwide health problem. No new antibiotics are expected to be available in the near future and few trials of colistin therapy have been performed in pediatric populations. Therefore, we evaluated the efficacy and safety of colistin in pediatric patients. A retrospective case series study was performed in the pediatric intensive care unit(PICU) of the Asan Medical Center. We collected clinical and demographic data on patients diagnosed with infections caused by multidrug-resistant Acinetobacter baumannii and/or Pseudomonas aeruginosa between January 2007 and October 2007. 12 patients received intravenous and/or nebulized colistin and 18 episodes of infections are caused by multidrug-resistant A.baumannii and P.aeruginosa. The overall mortality was 50%. Clinical response was observed in 28% and microbiological response was observed in 39% of episodes. Deterioration of renal function was observed in 67% of 9 patients who were not receiving renal replacement therapy before colistin administration(P<0.05). The major limitations of this study are the absence of a control group and co-administration of other antimicrobial agents. Therefore, we can’t definite any conclusions regarding the clinical effectiveness and safety of colistin. Additional researches to assess efficacy and safety of colistin are needed in pediatric populations.