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The use of polymyxins to treat carbapenem resistant infections in neonates and children.

Thomas, R; Velaphi, S; Ellis, S; Walker, AS; Standing, JF; Heath, P; Sharland, M; Dona', D (2018) The use of polymyxins to treat carbapenem resistant infections in neonates and children. Expert Opin Pharmacother, 20 (4). pp. 415-422. ISSN 1744-7666 https://doi.org/10.1080/14656566.2018.1559817
SGUL Authors: Heath, Paul Trafford Sharland, Michael Roy

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Abstract

INTRODUCTION: The incidence of healthcare-associated multidrug resistant bacterial infections, particularly due to carbapenem resistant organisms, has been on the rise globally. Among these are the carbapenem resistant Acinetobacter baumannii and Enterobacteriaceae, which have been responsible for numerous outbreaks in neonatal units. The polymyxins (colistin and polymyxin B) are considered to be the last resort antibiotics for treating such infections. However, pharmacokinetic and pharmacodynamic data on the use of polymyxins in neonates and children are very limited, and there are safety concerns. Areas covered: In this review, the authors summarize the global burden of multidrug resistance, particularly carbapenem resistance, in the neonatal and paediatric population, and the potential wider use of polymyxins in treating these infections. Expert opinion: Both colistin and polymyxin B have similar efficacy in treating multidrug resistant infections but have safety concerns. However, polymyxin B appears to be a better therapeutic option, with more rapid and higher steady state concentrations achieved compared to colistin and less reported nephrotoxicity. There is virtually no data in neonates and children currently; there is therefore an urgent need for pharmacokinetic and safety trials in these populations to determine the optimal drug and dosing regimens and provide recommendations for their use against carbapenem resistant infections.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Opinion on Pharmacotherapy on 21/12/18, available online: http://www.tandfonline.com/10.1080/14656566.2018.1559817
Keywords: Neonate, carbapenem resistance, colistin, multidrug resistance, polymyxin B, Neonate, carbapenem resistance, colistin, multidrug resistance, polymyxin B, 1115 Pharmacology And Pharmaceutical Sciences, Pharmacology & Pharmacy
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Expert Opin Pharmacother
ISSN: 1744-7666
Language: eng
Dates:
DateEvent
21 December 2018Published
12 December 2018Accepted
Publisher License: Publisher's own licence
PubMed ID: 30576264
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110506
Publisher's version: https://doi.org/10.1080/14656566.2018.1559817

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