Prospective randomized study comparing different colistin dosing regimens in paediatric cancer patient with MDR gram-negative infection or sepsis

The aim of this study is to:

1. Evaluate the clinical outcome of two different dosing regimen of IV colistin in the treatment of children with multidrug resistant gram-negative infections or sepsis.
2. To estimate the frequency of colistin associated adverse effects.
3. To correlate the serum colistin concentration and MIC to microbiological clearance and clinical outcome

Inclusion Criteria:

1. Age between one year and 18 years

2. All paediatric cancer patients who are prescribed intravenous colistin due to:

   • Sepsis due to MDR or minimally susceptible gram-negative bacteria
   • History of MDR gram-negative infection or sepsis due to organisms sensitive to colistin.
   • Culture result consistent with MDR gram negative for this febrile neutropenic episode.
   • Patient in sepsis and colistin was administered empirically to increase antibiotic coverage.

Exclusion Criteria:

1. Age less than one year or over 18 years
2. Patients with renal impairment
3. Colistin use less than 72 hours