Author(s): Ahmed S. Mancy, Sara Shaheen, Ayman Albaghdady, Nagwa A. Sabri

Email(s): ahmed.mancy17@gmail.com , ahmed.mancy@hu.edu.eg

DOI: 10.52711/0974-360X.2022.00177   

Address: Ahmed S. Mancy1*, Sara Shaheen2, Ayman Albaghdady3, Nagwa A. Sabri2
1Department of Pharmacy Practice, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt.
2Department of Clinical Pharmacy, Faculty of Pharmacy, Ain-Shams University, Cairo, Egypt.
3Department of Pediatric Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
*Corresponding Author

Published In:   Volume - 15,      Issue - 3,     Year - 2022


ABSTRACT:
Purpose: The aim of this study was to ensure the safety and efficacy of intravenous administration of colistin-imipenem/cilastatin combination to critically ill pediatrics suffering from multidrug-resistant gram-negative sepsis. Patients and methods: The study was designed to give sixty patients in Al-Demerdash hospital pediatric intensive care units (PICU), Ain Shams University, Cairo, Egypt, either imipenem/cilastatin as a monotherapy (thirty patients) or colistin-imipenem/cilastatin intravenously as a combination (thirty patients). The interventional prospective randomized study was performed with focusing on patients' hemodynamic parameters, vital signs, sepsis markers and microbiological response. Results: Thirty patients received intravenous colistin-imipenem/cilastatin combination; with median age of 8.5 months (range: 1-36 months). The isolated bacteria were Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli. Klebsiella pneumoniae was the most common isolate (51.7%) of the overall examined sixty patients. Patient who received the combination therapy, was associated with improving in vital signs and hemodynamic parameters with significant p = 0.001, and microbiological responses were represented by the recorded cultures. No patients were defined by renal impairment or neurological toxicity as a side effect to colistin therapy. However, non-significant differences in fatality was found among the two groups with p = 0.108. Conclusion: Colistin combination therapy resulted in better clinical outcomes of PICU patients, which were represented by eradication of the multidrug-resistant gram-negative bacteria without noticeable nephrotoxicity.


Cite this article:
Ahmed S. Mancy, Sara Shaheen, Ayman Albaghdady, Nagwa A. Sabri. Efficacy and safety of Colistin-Imipenem/Cilastatin combination Therapy for Multidrug-Resistant Gram-Negative Bacteria Infections in Critically Ill Pediatric Patients. Research Journal of Pharmacy and Technology. 2022; 15(3):1059-3. doi: 10.52711/0974-360X.2022.00177

Cite(Electronic):
Ahmed S. Mancy, Sara Shaheen, Ayman Albaghdady, Nagwa A. Sabri. Efficacy and safety of Colistin-Imipenem/Cilastatin combination Therapy for Multidrug-Resistant Gram-Negative Bacteria Infections in Critically Ill Pediatric Patients. Research Journal of Pharmacy and Technology. 2022; 15(3):1059-3. doi: 10.52711/0974-360X.2022.00177   Available on: https://rjptonline.org/AbstractView.aspx?PID=2022-15-3-20


REFERENCES:
1.    Rani, U.; Lewis, L. E.; Akthar, N.; Chawla, K., Prevention of Neonatal healthcare-associated infections: Current update. Research Journal of Pharmacy and Technology. 2020, 13 (6), 2771-2776. doi : 10.5958/0974-360X.2020.00492.8
2.    Abbas, H. A.; El-Saysed, M. A.; Ganiny, A. M.; Fattah, A. A., Antimicrobial Resistance Patterns of Proteus mirabilis isolates from Urinary tract, burn wound and Diabetic foot Infections. Research Journal of Pharmacy and Technology. 2018, 11 (1), 249-252. doi : 10.5958/0974-360X.2018.00046.X
3.    Anima, N.; Dhamodharan, S.; Nayak, B., Antibiotic Resistance Pattern Exhibited by Esbl (Extended Spectrum β-Lactamases) in Multidrug Resistant Strains, Escherichia coli. Research Journal of Pharmacy and Technology. 2017, 10 (11), 3705-3708. doi : 10.5958/0974-360X.2017.00672.2
4.    Abbas, H. A.; Kadry, A. A.; Shaker, G. H.; Goda, R. M., Resistance of Escherichia coli and Klebsiella pneumoniae isolated from different Sources to β-lactam Antibiotics. Research Journal of Pharmacy and Technology. 2017, 10 (2), 589-591. doi : 10.5958/0974-360X.2017.00116.0
5.    Nahar, N.; Naz, S.; Asad, S.; Rahman, M. M.; Ahmed, T.; Islam, K.; Aman, D.; Setu, N. I.; Kayser, S.; Islam, S., Analysis of the genotypic distribution of virulence and antibiotic resistance biomarkers of Listeria species in-silico. Research Journal of Pharmacy and Technology. 2018, 11 (6), 2173-2179. doi : 10.5958/0974-360X.2018.00402.X
6.    Livermore, D. M., Bacterial Resistance: Origins, Epidemiology, and Impact. Clinical Infectious Diseases. 2003, 36 (Supplement_1), S11-S23. doi.org/10.1086/344654
7.    Ahmad, R., Evaluation of the Gram-Negative bacilli causing Surgical-Site infections and their sensitivity to antibiotics in Al-Mowasat Hospital, Damascus, Syria. Research Journal of Pharmacy and Technology. 2018, 11 (5), 2070-2073. doi : 10.5958/0974-360X.2018.00384.0
8.    Karampatakis, T.; Tsergouli, K.; Iosifidis, E.; Antachopoulos, C.; Volakli, E.; Karyoti, A.; Sdougka, M.; Tsakris, A.; Roilides, E., Effects of an active surveillance program and enhanced infection control measures on carbapenem-resistant gram-negative bacterial carriage and infections in pediatric intensive care. Microbial Drug Resistance. 2019, 25 (9), 1347-1356. doi.org/10.1089/mdr.2019.0061
9.    Chaturvedi, R.; Chandra, P.; Mittal, V., Biofilm formation by Acinetobacter spp. in association with antibiotic resistance in clinical samples obtained from tertiary care hospital. Research Journal of Pharmacy and Technology. 2019, 12 (8), 3737-3742. doi : 10.5958/0974-360X.2019.00620.6
10.    Desai, S. M.; Undale, V. R., Antibiotic overuse and resistance: an awareness study. Research Journal of Pharmacy and Technology. 2019, 12 (6), 2794-2798. doi : 10.5958/0974-360X.2019.00470.0
11.    Falagas, M. E.; Karageorgopoulos, D. E., Pandrug resistance (PDR), extensive drug resistance (XDR), and multidrug resistance (MDR) among Gram-negative bacilli: need for international harmonization in terminology. Clinical Infectious Diseases. 2008, 46 (7), 1121-1122. doi.org/10.1086/528867
12.    Celebi, S.; Hacimustafaoglu, M.; Koksal, N.; Ozkan, H.; Çetinkaya, M., Colistimethate sodium therapy for multidrug‐resistant isolates in pediatric patients. Pediatrics International. 2010, 52 (3), 410-414. doi.org/10.1111/j.1442-200X.2009.03015.x
13.    Karnik, N. D.; Sridharan, K.; Jadhav, S. P.; Kadam, P. P.; Naidu, R. K.; Namjoshi, R. D.; Gupta, V.; Gore, M. S.; Surase, P. V.; Mehta, P. R.; Gogtay, J. A.; Thatte, U. M.; Gogtay, N. J., Pharmacokinetics of colistin in critically ill patients with multidrug-resistant Gram-negative bacilli infection. European Journal of Clinical Pharmacology. 2013, 69 (7), 1429-1436. doi: 10.1007/s00228-013-1493-9
14.    Jacobs, R. F.; Kearns, G. L.; Trang, J. M.; Brown, A. L.; Marmer, B.; McIntosh, J. C.; Underwood, F. L.; Kluza, R. B., Single-dose pharmacokinetics of imipenem in children. The Journal of Pediatrics. 1984, 105 (6), 996-1001. doi.org/10.1016/S0022-3476(84)80098-0
15.    Mohiuddin, G.; Gillani, S. W.; Azhar, A.; Majeed, R. A., Clinical Review: management of Lower respiratory tract infection in pediatric Population. Infection. 11, 14. doi.org/10.32463/RPHS.2019.v05i04.04
16.    Iosifidis, E.; Antachopoulos, C.; Ioannidou, M.; Mitroudi, M.; Sdougka, M.; Drossou-Agakidou, V.; Tsivitanidou, M.; Roilides, E., Colistin administration to pediatric and neonatal patients. European Journal of Pediatrics. 2010, 169 (7), 867-874. doi: 10.1007/s00431-009-1137-3
17.    Fridkin, S. K., Increasing prevalence of antimicrobial resistance in intensive care units. Critical care medicine 2001, 29 (4), N64-N68.
18.    Falagas, M. E.; Kasiakou, S. K.; Saravolatz, L. D., Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clinical Infectious Diseases. 2005, 40 (9), 1333-1341. doi.org/10.1086/429323
19.    Bharadwaj, S.; Teotia, U.; Singh, K.; Sharma, R.; Singh, Y., Effect of antibiotic on various microorganisms isolated from nosocomial infected patients in general hospital. Research Journal of Pharmacy and Technology. 2014, 7 (4), 408-414.
20.    Souli, M.; Rekatsina, P. D.; Chryssouli, Z.; Galani, I.; Giamarellou, H.; Kanellakopoulou, K., Does the activity of the combination of imipenem and colistin in vitro exceed the problem of resistance in metallo-β-lactamase-producing Klebsiella pneumoniae isolates? Antimicrobial Agents and Chemotherapy. 2009, 53 (5), 2133-2135. doi.org/10.1128/AAC.01271-08
21.    Santimaleeworagun, W.; Wongpoowarak, P.; Chayakul, P.; Pattharachayakul, S.; Tansakul, P.; Garey, K. W., In vitro activity of colistin or sulbactam in combination with fosfomycin or imipenem against clinical isolates of carbapenem-resistant Acinetobacter baumannii producing OXA-23 carbapenemases. Southeast Asian Journal of Tropical Medicineand Public Health 2011, 42 (4), 890.
22.    Yang, T.-Y.; Wang, S.-F.; Lin, J.-E.; Griffith, B. T. S.; Lian, S.-H.; Hong, Z.-D.; Lin, L.; Lu, P.-L.; Tseng, S.-P., Contributions of insertion sequences conferring colistin resistance in Klebsiella pneumoniae. International Journal of Antimicrobial Agents 2020, 55 (3), 105894. doi.org/10.1016/j.ijantimicag.2020.105894
23.    Salmon-Rousseau, A.; Martins, C.; Blot, M.; Buisson, M.; Mahy, S.; Chavanet, P.; Piroth, L., Comparative review of imipenem/cilastatin versus meropenem. Médecine et Maladies Infectieuses 2020, 50 (4), 316-322. doi.org/10.1016/j.medmal.2020.01.001
24.    Bergen, P. J.; Forrest, A.; Bulitta, J. B.; Tsuji, B. T.; Sidjabat, H. E.; Paterson, D. L.; Li, J.; Nation, R. L., Clinically relevant plasma concentrations of colistin in combination with imipenem enhance pharmacodynamic activity against multidrug-resistant Pseudomonas aeruginosa at multiple inocula. Antimicrobial Agents and Chemotherapy. 2011, 55 (11), 5134-5142. doi.org/10.1128/AAC.05028-11
25.    Su, E.; Crowley, K.; Carcillo, J. A.; Michaels, M. G., Linezolid and lactic acidosis: a role for lactate monitoring with long-term linezolid use in children. The Pediatric Infectious Disease Journal. 2011, 30 (9), 804. doi: 10.1097/INF.0b013e3182186035
26.    Couto, R. C.; Carvalho, E. A.; Pedrosa, T. M.; Pedroso, Ê. R.; Neto, M. C.; Biscione, F. M., A 10-year prospective surveillance of nosocomial infections in neonatal intensive care units. American Journal of Infection Control. 2007, 35 (3), 183-189. doi.org/10.1016/j.ajic.2006.06.013
27.    Zhao, S.; Fan, L.; Feng, J.; Ma, P., Reversible black tongue: A little known side effect of imipenem/cilastatin and evidence for novel mode of action. Journal of Clinical Pharmacy and Therapeutics. 2020, 45 (2), 370. doi: 10.1111/jcpt.13066
28.    Nagy, B.; Gaspar, I.; Papp, A.; Bene, Z.; Nagy Jr, B.; Voko, Z.; Balla, G., Efficacy of methylprednisolone in children with severe community acquired pneumonia. Pediatric Pulmonology 2013, 48 (2), 168-175. doi.org/10.1002/ppul.22574
29.    Verwaest, C.; Group, B. M. S., Meropenem versus imipenem/cilastatin as empirical monotherapy for serious bacterial infections in the intensive care unit. Clinical Microbiology and Infection 2000, 6 (6), 294-302. doi.org/10.1046/j.1469-0691.2000.00082.x

Recomonded Articles:

Research Journal of Pharmacy and Technology (RJPT) is an international, peer-reviewed, multidisciplinary journal.... Read more >>>

RNI: CHHENG00387/33/1/2008-TC                     
DOI: 10.5958/0974-360X 

0.38
2018CiteScore
 
56th percentile
Powered by  Scopus


SCImago Journal & Country Rank


Recent Articles




Tags


Not Available