Clinical outcome of pediatric patients using polymyxin B

Resumo

ABSTRACT
Objective: to evaluate the clinical effectiveness and safety of polymyxin B in the treat
ment of infections caused by bacteria resistant to multiple drugs. Methods: a retrospec
tive cohort was carried out, evaluating the medical records of diagnosed patients with
infections caused by bacteria resistant to multiple drugs and treated with polymyxin B
(from January 2018 to December 2020, in intensive care units of a pediatric hospital in
Salvador – Ba. Safety was assessed using the nephrotoxicity criteria established by Kid
ney Disease: Improving Global Outcomes. Results: a total of 39 patients used polymyxin
B for infections caused by bacteria resistant to multiple drugs, with treatment success
being achieved in 13 (33.3%) patients with clinical and/or microbiological cure, while
the Mortality was observed in 26 (66.6%) patients, of which 19 (73%) were described
in a medical report as death related to infection and 7 (27%) were associated with
complications from comorbidities. The occurrence of kidney injury was reported in 21
patients, of which 6 were discarded to do renal damage before the use of polymyxin B,
15 (38.4%) with a rate of nephrotoxicity classified as stages 1, 2, and 3, according to
the Kidney Disease: Improving Global Outcomes criteria. Conclusion: approximately one
third of patients were clinically and microbiologically cured. It is necessary to carefully
evaluate treatment with polymyxin B, prioritizing multidrug-resistant infections, rational
use and attention to monitoring renal function.
Keywords: multidrug resistance; polymyxin B; drug toxicity; child; Bacterial resistance.