Effectiveness and adverse effects of Intravenous Colistin In Neonates with Multi-Drug Resistant Gram-Negative Bacterial Infections

Background@#The global burden of multi-drug resistant gram-negative bacterial (MDR-GNB) infections has been increasing. Neonates are at a particularly high-risk and there is limited treatment option. The use of colistin has been re-introduced for this population. However, data on its use in neonates is scarce. @*Objectives@#To determine the effectiveness and adverse effects of intravenous colistin in neonates with multidrug-resistant gram-negative infections. @*Design@#This is a retrospective cohort study of the clinical profile and outcome of neonates with MDR-GNB infections given colistin for a minimum of 3 days conducted from April 2015 to April 2019. @*Results@#A total of 175 pediatric patients had MDR-GNB infections. 75 (43%) neonates met the inclusion criteri a and received intravenous colistin. Of the 75 patients with MDRGNB infections- that included sepsis, pneumonia, urinary tract infection and abscess, 37 (49.3%) were alive and 38 (50.7%) patients died. Nephrotoxicity was seen in 4% if patients and 2.6% patients had hypersensitivity reaction. MDROs isolated were Acinetobacter baumanii, Klebsiella pneumoniae and Pseudomonas aeruginosa. @*Conclusions@#Intravenous colistin is 50% effective and is relatively safe to use in neonates.

A randomized double blind controlled study on the efficacy of spirulina as an adjunct therapy in the management of pediatric community acquired pneumonia-c in patients 6 months to 5 years old admitted in a tertiary government hospital

OBJECTIVE@#To determine the effect of Spirulina among patients with community acquired Pneumonia-C (PCAP-C) based on the resolution of the following symptoms; fever, respiratory rate, chest indrawings, rales, oxygen saturation and compare their length of hospital stay.@*DESIGN@#A randomized-double blind, placebo controlled clinical trial.@*SETTING@#The study was done at a tertiary government hospital@*PATIENTS/PARTICIPANTS@#Children 6 months to 5 years old with PCAP-C were randomized to either treatment group A or B. The two groups received the standard treatment for pneumonia and adjunct treatment of Spirulina for group A and placebo for group B.@*RESULTS@#A total of 14 7 patients participated in the study. Seventy four patients were randomized to group A and 73 patients to group B. Respiratory rate showed greater improvement with Spirulina supplementation starting day 3, 4 and 5. Resolution of chest in-drawing was significant in Spirulina group on day 2 (p- value < 0.05), day 3 (p - value < 0.05) and day 4 (p - value <0.05). There were more patients in Spirulina group with decreased to absent rales on day 2 (p-value 0.02), day 3 (p-value 0.039), day 4 (p-value 0.01) and day 5 (p-value 0.01). Temperature and oxygen saturation on both groups had almost similar trends. The mean hospital stay in Spirulina group (3.09 days) is shorter as compared to the placebo group (p-value 0.02).@*CONCLUSION@#Spirulina supplementation showed positive effects in PCAP-C. Its immunemodulating effect played a positive role in the treatment outcome of pneumonia.