Use of Tigecycline in Neonates with Extensively Drug Resistant Organisms Infections in Neonatal Units of Queen Sirikit National Institute of Child Health
Keywords:Multidrug-resistant, Tigecycline, Neonate
Background: Tigecycline is a broad spectrum antibiotic with restricted indications in paediatrics patients.
Its use in clinical practice is reserved for cases with challenging infections due to multi-drug resistant bacteria. Limited data is available to determine the treatment outcome in neonates.
Objective: To study the survival rate of antibiotic resistant newborn patients who were treated with tigecycline at Queen Sirikit National Institute of Child Health (QSNICH).
Method: A retrospective descriptive study was conducted by extracting data from medical records of patients admitted in neonatal units of QSNICH who were treated with tigecycline between 1st January, 2014 and 30th September, 2018.
Result: There were 4,362 neonatal admission during this period with 82 patients included in the study. The average gestational age was 30.13 ± 4.42 weeks. Three most common XDR pathogens identified were K. pneumoniae (54%), P. aeruginosa (24.1%) and A. baumannii (19.5%). Tigecycline was used most frequently for the treatment of pneumonia; 34 cases (41.46%) and septicemia 27 cases (32.93%). The survival rate was 86.58%. Comparison of mortality rate between two different doses (2 and 2.4 mg/ kg/ day) showed no statistical significant difference (p=0.44). Three cases of septic shock developed acute kidney injury, before starting tigecycline, died later.
Conclusion: Tigecycline can be used in neonates infected with extensive drug resistance organism. Safety of tigecycline use in neonates should be considered.
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