title: Is colistin effective in the treatment of infections caused by multidrug-resistant (MDR) or extremely drug-resistant (XDR) gram-negative microorganisms in children?
abstract: The increasing incidence of infections caused by multidrug-resistant (MDR) or extremely drug-resistant (XDR) gram-negative organisms has led to the reemergence of colistin use. Clinical and demographic data were collected on 94 pediatric patients diagnosed with MDR or XDR gram-negative infections and treated with either a colistin-containing regimen (colistin group) or at least one antimicrobial agent other than colistin (noncolistin group). The overall clinical response rates were 65.8% in the colistin group and 70.0% in the noncolistin group (P = 0.33). The infection-related mortality rates were 11% in the colistin group and 13.3% in the noncolistin group (P = 0.74). There was no statistically significant difference in nephrotoxicity in the colistin and noncolistin groups. Colistin therapy was at least as effective and as safe as beta-lactam antibiotics or quinolones, with or without aminoglycosides, in the treatment of infections caused by gram-negative organisms and may be a therapeutic option in children.
authors.affiliation: Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey. Electronic address: yas.oguz99@yahoo.com.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Ozsurekci
authors.affiliation: Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Kubra
authors.initials: K
authors.lastname: Aykac
authors.affiliation: Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ali Bulent
authors.initials: AB
authors.lastname: Cengiz
authors.affiliation: Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Cihangul
authors.initials: C
authors.lastname: Bayhan
authors.affiliation: Department of Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Sancak
authors.affiliation: Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Karadag Oncel
authors.affiliation: Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ates
authors.initials: A
authors.lastname: Kara
authors.affiliation: Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ceyhan
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003091:Colistin / Q000009:adverse effects / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D051437:Renal Insufficiency / Q000139:chemically induced / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin
keywords: Bacterial resistance; Childhood; Colistin; Extremely drug resistant (XDR); Multidrug resistant (MDR)