title: Colistin use in pediatric intensive care unit for severe nosocomial infections: experience of an university hospital.
abstract: BACKGROUND
  The aim of this study was to investigate the efficacy and safety of colistin therapy in pediatric patients with severe nosocomial infections in pediatric intensive care unit.
  
  
  METHODS
  The medical records of patients treated with colistin at a 200-bed university children hospital were reviewed.
  
  
  RESULTS
  Thirty-one patients (male/female = 22/9; median age, 3 years; range, 3 months-17 years) received forty-one courses of colistin. The average dose of colistin was 4.9 ± 0.5 mg/kg/day and average treatment duration was 19.8 ± 10.3 days. Three patients who received concomitant nephrotoxic agent with colistin developed nephrotoxicity. Colistin treatment was well tolerated in other patients, and neurotoxicity was not seen in any patient. Favourable outcome was achieved in 28 (68.3%) episodes. Twelve patients died during the colistin therapy. Six of these patients died because of primary underlying disease. The infection-related mortality rate was found 14.6% in this study.
  
  
  CONCLUSIONS
  In our study, colistin therapy was found to be acceptable treatment option for the severe pediatric nosocomial infections caused by multi-drug resistant bacteria. However, the use of concomitant nephrotoxic drugs with colistin must be avoided and renal function test should be closely monitored.
authors.forename: Arzu
authors.initials: A
authors.lastname: Karli
authors.affiliation: Faculty of Medicine, Pediatric Intensive Care Unit, Ondokuz Mayis University, Samsun, Turkey. sukrupaksu@yahoo.com.
authors.forename: Muhammet Sukru
authors.initials: MS
authors.lastname: Paksu
authors.forename: Adil
authors.initials: A
authors.lastname: Karadag
authors.forename: Nursen
authors.initials: N
authors.lastname: Belet
authors.forename: Sule
authors.initials: S
authors.lastname: Paksu
authors.forename: Akif Koray
authors.initials: AK
authors.lastname: Guney
authors.forename: Muhammet
authors.initials: M
authors.lastname: Akgun
authors.forename: Nazik
authors.initials: N
authors.lastname: Yener
authors.forename: Sema Gulnar
authors.initials: SG
authors.lastname: Sensoy
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003091:Colistin / Q000009:adverse effects / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin