Abou Sedira, Y., El Wakeel, L., Omran, M., Sidhom, I., Shouman, S. (2022). Colistin Pharmacokinetics in Pediatric Cancer Patients in Egypt. Archives of Pharmaceutical Sciences Ain Shams University, 6(2), 208-220. doi: 10.21608/aps.2022.166621.1099
Yosr Abou Sedira; Lamia El Wakeel; Mervat Omran; Iman Sidhom; Samia Shouman. "Colistin Pharmacokinetics in Pediatric Cancer Patients in Egypt". Archives of Pharmaceutical Sciences Ain Shams University, 6, 2, 2022, 208-220. doi: 10.21608/aps.2022.166621.1099
Abou Sedira, Y., El Wakeel, L., Omran, M., Sidhom, I., Shouman, S. (2022). 'Colistin Pharmacokinetics in Pediatric Cancer Patients in Egypt', Archives of Pharmaceutical Sciences Ain Shams University, 6(2), pp. 208-220. doi: 10.21608/aps.2022.166621.1099
Abou Sedira, Y., El Wakeel, L., Omran, M., Sidhom, I., Shouman, S. Colistin Pharmacokinetics in Pediatric Cancer Patients in Egypt. Archives of Pharmaceutical Sciences Ain Shams University, 2022; 6(2): 208-220. doi: 10.21608/aps.2022.166621.1099
Colistin Pharmacokinetics in Pediatric Cancer Patients in Egypt
1Department of Clinical Pharmacy, National Cancer Institute, Cairo University, Cairo, Egypt
2Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Abbassia, Cairo 11566, Egypt
3Pharmacology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
4Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt Pediatric Oncology department, Children's Cancer Hospital Egypt
Abstract
Background: Colistin has been reintroduced to clinical practice after the emergence of multidrug-resistant gram-negative (MDR-GN) and failure of other antibiotics. Pharmacokinetics and pharmacodynamic data in pediatric population are scarce. This study aimed to highlight the pharmacokinetics of 2 colistin doses, 2.5 and 5mg/kg/day, in febrile neutropenia pediatrics cancer patients regarding patient outcomes. Patients and methods: In a prospective, comparative study, patients suffering from MDR-GN infection were randomly recruited to receive either 2.5 or 5mg/kg/day colistin doses. The demographic, microbiological, and treatment outcomes were collected before and after treatment. Colistin levels were determined using HPLC/MS/MS. Peak, trough, area under the concentration-time curve (AUC24), and the ratio of AUC24 to the minimum inhibitory concentration (AUC24/MIC) were assessed. Results. Clinical cure was achieved in 14(77.8%) cases in the Low-Dose (LD) group vs. 13(81.3%) in the High-Dose (HD) group. Four (25%) patients vs. 4(33.3%) in the LD and HD group (P=0.69) attained an optimal plasma AUC24/MIC, respectively, while the therapeutic level of colistin was reached in all patients in the LD group compared to 14/16 (87.5%) in the HD group. Microbiological eradication was achieved in (93.8%) and (91.6%) of patients in the LD and HD groups, respectively. However, the median time to clearance was significantly lower in the LD group, 4 days vs. 7 days in the HD group (P=0.022). Conclusion: The current study suggests that the LD may be as efficacious and safe as the HD in treating MDR-GN infection. However, LD colistin was associated with a shorter clearance time than HD colistin.
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