A retrospective study on the outcome of children with extensively drug-resistant gram-negative infection treated with Colistin vs. other Antimicrobials
https://doi.org/10.56964/pidspj20181901008
- Author:
Carren Anne P. Batalla - Bocaling
1
;
Estrella B. Paje - Villar
1
Author Information
1. Philippine Childrens Medical Center
- Publication Type:Journal Article
- Keywords:
Extensively drug-resistant gram-negative infection
- MeSH:
Cross Infection;
Colistin
- From:
Pediatric Infectious Disease Society of the Philippines Journal
2018;19(1):54-64
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:The increasing trend of extensively drug-resistant gram-negative infections led to the reconsideration of colistin as a valuable therapeutic option.
Objectives:To describe the clinical profile and treatment response of children with extensively drug resistant (XDR) Gram-negative infections given colistin versus other antimicrobials.
Methods:This retrospective descriptive study involved patients treated for XDR Gram-negative infections from January 2014 to June 2017 in a tertiary hospital in Metro Manila. Descriptive statistics were used to summarize clinical characteristics of subjects. Treatment response to colistin versus other antimicrobial agents were compared in terms of success, failure, and toxicity. The Fisher-exact and Mann Whitney U tests were used to assess statistical differences between the colistin and non-colistin groups.
Results:Majority of patients with XDR Gramnegative infections had previous antibiotic exposure.
More patients in the colistin group received TPN 43.2% vs 23.7% (p=0.035), had a longer hospital stay prior to the onset of XDR Gram-negative infection, 27 days vs. 15.5 days (p=0.001), and had a longer total hospital stay with a median of 52 days vs 30 days (p < 0.001). Treatment success was significantly higher in the colistin group at 70.3%, as against 46.5% in the non-colistin group (p=0.014). There was no difference in the treatment duration of both groups. The colistin group had longer time to clinical response, with a mean of 6.27 (+ 3.57) days compared with those from the non-colistin group, with a mean of 4.36 (+ 1.77)(p=0.008). The colistin group had more fungal infections during the course of treatment (p=0.001).
Conclusion:Based on our institutional experience, colistin is considered relatively effective and safe in treating XDR Gram-negative infections in children.
- Full text:jo54_ja07.pdf
