Short-term outcomes of neonates with severe sepsis on intravenous colistin therapy – A prospective study.

This article focuses on evaluating the short-term outcomes and nephrotoxicity associated with intravenous colistimethate sodium (Colistin) therapy in neonates with severe sepsis in a special neonatal care unit (SNCU) facing high multidrug resistance (MDR). In a prospective study of 135 neonates, a survival rate of 52.6% was observed, with only 2.2% developing acute kidney injury (AKI), despite 17.5% of Gram-negative bacterial isolates showing resistance to Colistin. The most common Gram-negative pathogens included Burkholderia cepacia, Klebsiella pneumoniae, and Acinetobacter baumannii, with Colistin used as a reserve antibiotic often in combination with other drugs. Independent risk factors for mortality included platelet transfusion and the need for high-frequency oscillatory ventilation, while no significant nephrotoxicity or major electrolyte disturbances were linked to Colistin use. The study concludes that Colistin remains a reasonable treatment option in NICUs with high MDR incidence, emphasizing the importance of antibiotic stewardship and infection control measures.