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Choosing antibiotics in MDRO infections in NICU ? Dr Sachin Shah MD (Pediatrics), DM (Neonatology) Fellowship in Neonatology (Australia and Canada) Fellowship in Pediatric critical care (Canada) Director, Neonatal and Pediatric Intensive care services

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Page 1: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Choosing antibiotics in MDRO infections in NICU

Dr Sachin ShahMD (Pediatrics) DM (Neonatology)

Fellowship in Neonatology (Australia and Canada)

Fellowship in Pediatric critical care (Canada)

Director

Neonatal and Pediatric Intensive care services

Case based approach

MDR organisms

Newer antibiotics

Rationale approach

MDRO ndash Organisms resistant to one or

more classes of antibiotics

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

Primi 35 years old IVF pregnancy Twins

DCDA

Leaking started at 24 weeks Cervical stitch

insitu on and off leak Managed

conservatively

At 25 weeks developed fever

Received IV piperacillin tazobactum

Emergency LSCS at 25+2 weeks in vo

suspected chorioamnionitis

Twin 1 ndash intact membranes

Twin 2 ndash ruptured sac

Both cried at birth and stabilised on CPAP

BW 700 gms and 720 gms

Antibiotic options

Twin 1

Twin 2

Same or different

1st line 2nd line 3rd line

Wait for maternal cs

Depending on clinical scenario and lab

work

Clinical course

Twin 1 ndash CPAP 30 FiO2 Mild RDS

CBC ndash normal

Cs ndash awaited

Twin 2 - same as above

Routine preterm care given

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 2: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Case based approach

MDR organisms

Newer antibiotics

Rationale approach

MDRO ndash Organisms resistant to one or

more classes of antibiotics

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

Primi 35 years old IVF pregnancy Twins

DCDA

Leaking started at 24 weeks Cervical stitch

insitu on and off leak Managed

conservatively

At 25 weeks developed fever

Received IV piperacillin tazobactum

Emergency LSCS at 25+2 weeks in vo

suspected chorioamnionitis

Twin 1 ndash intact membranes

Twin 2 ndash ruptured sac

Both cried at birth and stabilised on CPAP

BW 700 gms and 720 gms

Antibiotic options

Twin 1

Twin 2

Same or different

1st line 2nd line 3rd line

Wait for maternal cs

Depending on clinical scenario and lab

work

Clinical course

Twin 1 ndash CPAP 30 FiO2 Mild RDS

CBC ndash normal

Cs ndash awaited

Twin 2 - same as above

Routine preterm care given

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 3: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

MDRO ndash Organisms resistant to one or

more classes of antibiotics

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

Primi 35 years old IVF pregnancy Twins

DCDA

Leaking started at 24 weeks Cervical stitch

insitu on and off leak Managed

conservatively

At 25 weeks developed fever

Received IV piperacillin tazobactum

Emergency LSCS at 25+2 weeks in vo

suspected chorioamnionitis

Twin 1 ndash intact membranes

Twin 2 ndash ruptured sac

Both cried at birth and stabilised on CPAP

BW 700 gms and 720 gms

Antibiotic options

Twin 1

Twin 2

Same or different

1st line 2nd line 3rd line

Wait for maternal cs

Depending on clinical scenario and lab

work

Clinical course

Twin 1 ndash CPAP 30 FiO2 Mild RDS

CBC ndash normal

Cs ndash awaited

Twin 2 - same as above

Routine preterm care given

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 4: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

Primi 35 years old IVF pregnancy Twins

DCDA

Leaking started at 24 weeks Cervical stitch

insitu on and off leak Managed

conservatively

At 25 weeks developed fever

Received IV piperacillin tazobactum

Emergency LSCS at 25+2 weeks in vo

suspected chorioamnionitis

Twin 1 ndash intact membranes

Twin 2 ndash ruptured sac

Both cried at birth and stabilised on CPAP

BW 700 gms and 720 gms

Antibiotic options

Twin 1

Twin 2

Same or different

1st line 2nd line 3rd line

Wait for maternal cs

Depending on clinical scenario and lab

work

Clinical course

Twin 1 ndash CPAP 30 FiO2 Mild RDS

CBC ndash normal

Cs ndash awaited

Twin 2 - same as above

Routine preterm care given

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 5: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Case

Primi 35 years old IVF pregnancy Twins

DCDA

Leaking started at 24 weeks Cervical stitch

insitu on and off leak Managed

conservatively

At 25 weeks developed fever

Received IV piperacillin tazobactum

Emergency LSCS at 25+2 weeks in vo

suspected chorioamnionitis

Twin 1 ndash intact membranes

Twin 2 ndash ruptured sac

Both cried at birth and stabilised on CPAP

BW 700 gms and 720 gms

Antibiotic options

Twin 1

Twin 2

Same or different

1st line 2nd line 3rd line

Wait for maternal cs

Depending on clinical scenario and lab

work

Clinical course

Twin 1 ndash CPAP 30 FiO2 Mild RDS

CBC ndash normal

Cs ndash awaited

Twin 2 - same as above

Routine preterm care given

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 6: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Emergency LSCS at 25+2 weeks in vo

suspected chorioamnionitis

Twin 1 ndash intact membranes

Twin 2 ndash ruptured sac

Both cried at birth and stabilised on CPAP

BW 700 gms and 720 gms

Antibiotic options

Twin 1

Twin 2

Same or different

1st line 2nd line 3rd line

Wait for maternal cs

Depending on clinical scenario and lab

work

Clinical course

Twin 1 ndash CPAP 30 FiO2 Mild RDS

CBC ndash normal

Cs ndash awaited

Twin 2 - same as above

Routine preterm care given

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 7: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Antibiotic options

Twin 1

Twin 2

Same or different

1st line 2nd line 3rd line

Wait for maternal cs

Depending on clinical scenario and lab

work

Clinical course

Twin 1 ndash CPAP 30 FiO2 Mild RDS

CBC ndash normal

Cs ndash awaited

Twin 2 - same as above

Routine preterm care given

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 8: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Clinical course

Twin 1 ndash CPAP 30 FiO2 Mild RDS

CBC ndash normal

Cs ndash awaited

Twin 2 - same as above

Routine preterm care given

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 9: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Motherrsquos HVS isolated Klebsiella

Blood cs of twin 2 also isolated Klebsiella

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 10: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

ESBL infections

ESBLs hydrolyze broad range of beta

lactams including penicillin cephalosporins

but not carbapenems

GNB ndash Ecoli Klebsiella Proteus etc

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 11: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Beta lactam ndash Beta lactamase

inhibitor in ESBL infections

BL-BLI combination generally have in vitro

activity against organisms possessing a single

ESBL

Many organisms now produce multiple

ESBLs simultaneously

Reduces the effectiveness of the BL-BLI

resulting in in vitro resistance

Therapeutic failure with BL-BLIs may occur

in high-inoculum infections

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 12: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Small observational studies of neonates

infected with ESBL-producing organisms

found no difference in outcomes of neonates

receiving BL-BLIs or carbapenems

These studies had insufficient power to detect

a difference if one exists

BL-BLI is a reasonable treatment option for

ESBL-producing GNB from a urinary source

when appropriate dosing is used

bullPillay T et al Piperacillintazobactam in the treatment of Klebsiella pneumoniae

infections in neonates Am J Perinatol 1998 1547ndash51

bullVelaphi S et al Mortality rate in neonates infected with extended-spectrum beta

lactamase-producing Klebsiella species and selective empirical use of meropenem

Ann Trop Paediatr 200929101ndash10

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 13: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Fluroquinolones

Excellent tissue penetration

Useful as combination therapy

Ciprofloxacin

Single report of use in neonates

Children 20-30 mgkgday in 2 divided

doses

Prolongs QT interval

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 14: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Carbapenems

Drug of choice

Meropenem or Imipenem- Cilastatin

Ertapenem ndash UTI or SSTI

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 15: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Meropenem is the preferred carbapenem in

newborn infants as the safety profiles of

other carbapenems have not been

established in neonates

Gentamicin resistance is common

Amikacin or netilmicin which are resistant

to the aminoglycoside-modifying enzymes

of the bacteria can be used in patients who

are infected with a gentamicin-resistant

pathogen

Hoban DJ et al In vitro activity of three carbapenem antibiotics Comparative

studies with biapenem (L-627) imipenem and meropenem against aerobic pathogens

isolated worldwide Diagn Microbiol Infect Dis 1993 17299

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 16: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

ESBLs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 17: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

MDRO infection is associated with

Increased mortality

Increased morbidity

Increased length of stay

Increased cost of care

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 18: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Biggest problem today

Development of MDRO has outpaced

development of newer antibiotics

Very few antibiotics in pipeline

Acquired from community also

Maintain a balance between appropriate

initial antibiotic coverage and prevention of

resistance

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 19: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Pharmacokinetic and

pharmacodynamic aspects

Concentration dependent killing ndash higher

concentration (high peak)ndash better

eradication of bacteria

Aminoglycosides fluroquinolones colistin

Maximal efficacy seen with larger doses

given less frequently

Doses limited by toxicity

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 20: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Concentration independent killing

Maximum efficacy achieved with

maintaining drug concentration above the

pathogensrsquo minimum inhibitory

concentration (MIC)

More frequent administration to keep conc

above MIC for atleast 50-70 of the dosing

interval

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 21: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Rising MICs for most pathogens

Doses in NICU may be higher than that in

community

Cephalosporins carbapenems penicillins

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 22: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Case 2

3 weeks old baby transferred to Surya

Born at 31 weeks BW 1400 grams

CIAB had mild RD at birth and given

CPAP

Weaned off CPAP on day 5

Developed feeding intolerance and bilious

aspirates

Low platelets Given RDP

Meropenemamikacin given

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 23: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Settled clinically for few days

But not tolerating feeds

3 weeks ndash Abdominal distension with

perforation and shifted

Blood cs - Enterobacter

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 24: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Options

Supportive care continued

Antibiotics

Ventilation Drain done

Exploratory laparotomy ndash Distal ileostomy

done after 48 hours

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 25: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Carbapenem resistant GNBs

Carbapenem resistant enterobacter (CRE)

Carbapenem resistant acinetobacter

Carbapenem resistant pseudomonas

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 26: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

CRE ndash some caveats

Carbapenemase production does not always

translate to clinical failure with carbapenems

Therapeutic efficacy has been reported at

approximately 70 for MICs of 4 μgmL

(reported as resistant according to current CLSI

guidelines) no different from MICs le2 μgmL

Mainstay of treatment for CRE is combination

therapy

More efficacious than monotherapy

Tzouvelekis LS et al Carbapenemases in Klebsiella pneumoniae and other

Enterobacteriaceae an evolving crisis of global dimensions Clin Microbiol Rev

2012 25682ndash707

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 27: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Prolonged infusion carbapenem

therapy

Bacterial killing is enhanced when the non protein

bound lactam concentration exceeds the MIC ( fT

gtMIC) of the organism at least 40 of the time

for carbapenems

Intermittent dosing can lead to precipitous drops

in serum drug concentrations as meropenem is

rapidly cleared through the kidneys

Prolonging the infusion leads to a higher

probability of achieving target fTgtMIC

Tamma PD Jenh AM Milstone AM Prolonged beta-lactam infusion for gram-negative

Infections Pediatr Infect Dis J 201130336ndash7

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 28: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Meropenem dose of 40 mgkgdose

intravenously every 8 hours reliably

achieves this target for MICs le2 μgmL

For MICs of 4ndash8 μgmL a prolonged

infusion of meropenem over 3 hours can be

used for target attainment

Courter JD et al Optimizing bactericidal exposure for beta-lactams using prolonged

and continuous infusions in the pediatric population Pediatr Blood Cancer 2009

53379ndash85

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 29: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Polymixins

Polymixin B and Polymixin E (Colistin)

Similar profile

Polymyxin B does not have a prodrug Given in the

form of its active microbiological agent

Adult data suggest that nephrotoxicity is less

concerning with this agent compared with colistin as

urinary excretion is minimal

Pharmacokinetic studies have not been conducted in

children and limited clinical experience in pediatrics

population is limited

Dara JS CL et al Microbiological and genetic characterization of carbapenem-resistant

Klebsiella pneumoniae isolated from pediatric patients J Ped Infect Dis 2013 11ndash5

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 30: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Colistin

Colistin is administered parenterally in the

form of its inactive prodrug colistimethate

sodium (CMS) which is slowly and

incompletely converted to colistin (~20

conversion in vivo by enzymatic hydrolysis)

Bactericidal concentration dependent kiling

Kassamali Z et al Clin Infect Dis 201357877ndash83

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 31: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

CMS is cleared by kidney

Conversion of CMS to colistin is slow and

unpredictable

Even after administering a loading dose

several hours of delay occurs before

achievement of the maximum serum

concentration of colistin

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 32: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Colistin

Rapid clearance of CMS may reduce the

systemic availability of colistin to levels

insufficient to overcome infections

The utility of a loading dose has not yet

been evaluated in children

Seems logical approach

Suggested intravenous loading dose of

50000unitskg

25000-40000unitskg 8 hourly

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 33: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Hypomagnesemia hyponatremia and

hypokalemia have also been reported in

neonates receiving colistin therapy

Thomas R et al The use of polymyxins to treat carbapenem resistant infections in neonates and

children Expert Opinion on Pharmacotherapy 2018DOI 1010801465656620181559817

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 34: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Tigecycline Broad-spectrum bacteriostatic agent

Minocycline derivative

Tigecycline monotherapy was associated with

increased mortality compared with other regimens in

meta-analysis of randomized trials

Possibly due to unfavorable pharmacokinetics

Serum concentrations peak at lt1 μgmL and

promptly decline due to rapid tissue distribution

Yahav D et al Efficacy and Safety of tigecyclinea systematic review and meta-analysis

J Antimicrob Chemother 2011 661963ndash71

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 35: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Tigecycline

Not effective against Pseudomonas Aeruginosa

and Proteus Mirabilis

Not FDA approved in children

European medicines agency (EMA)- age gt 8 years

Duration of therapy 5 -14 days

Suggested doses are 12 mgkg every 12 hours iv

to a maximum dose of 50 mg every 12 hours for

children aged 8 to 11 years and 50 mg every 12

hours for adolescents aged 12 to 17 years

Expert Rev Anti Infect Ther 2017 Jun15(6)605-612

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 36: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Tigecycline

Use in combination with other active agents may

be considered when alternative treatment options

are exhausted

Limited experience in Pediatrics

Tigecycline may cause permanent teeth

discoloration and enamel hypoplasia in children

aged lt8 years

Purdy J et al Pharmacokinetics and safety profile of tigecycline in children aged 8 to

11 years with selected serious infections a multicenter open-label ascending-dose

study Clin Ther 2012 34496ndash507e491

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 37: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

First line drugs Second line drugs

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 38: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Hsu AJ Tamma PD Treatment of multidrug resistant gram negative infections in

children Clinical infectious Diseases 2014581439-48

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 39: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Case

34 weeks 1400 grams BW 14 days old

Delivered by emergency LSCS in vo

maternal leak with severe oligohydramnios

Baby said to have cried at birth APGAR

not known

Baby was shifted to nicu for respiratory

distress was put on oxygen Given

ceftriaxone and amikacin PICC inserted

Developed abdominal distension with feed

intolerance and kept NBM PPN given

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 40: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Developed fever on day 3 of life

Septic work up repeated

iv antibiotics upgraded ndash Meropenem

tigecycline colistin clindamycin at various

stages received IVIg

CSF examination done PICC replaced

Baby had thrombocytopenia received RDP

and PCV

Baby shifted to Surya hospital on parental

request and retrieved by SMCH team for

further care on day 14

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 41: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Colistin carbapenem resistant

Klebsiella (C-C-RKp)

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 42: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Options

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 43: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Fosfomycin

Belongs to Epoxide class of antibiotics

Unrelated to any other class of Abs

Broad spectrum against Gram +ve and

Gram ndashve

Bactericidal

Expert Rev Anti Infect Ther 2017 Oct15(10)935-945

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 44: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Good tissue penetration

Usually used as combination therapy in

XDR patients who are very sick as a last

resort

Response rate in adult 50-90

Hpernatremia and hypokalemia ndash very

common

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 45: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Resistance can develop very fast esp

amongst Pseudomonas

Should be used with synergestic antibiotics

such as genta amikacin etc

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 46: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Dose

lt 40 weeks CGA ndash 50 mgkg BD

40-44 weeks ndash 200 mgkgday in 3 divided

doses

Frequent monitoring of SE is needed

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 47: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

In SMCH

Continued inj Meropenem

Fosfomycin

Blood culture grew Klebsiella- Pan Drug

resistant

The baby had persistent low borderline

platelets

CSF so meningitis

Repeat blood culture after 7 days was sterile

IV antibiotics were given for 3 weeks

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 48: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

All other organs normal

Baby discharged home after 3 weeks

Comments

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 49: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Infection control

Contact precautions

Hand hygiene

Minimizing the use of invasive devices

Antimicrobial stewardship

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 50: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Active surveillance

Screening high-risk patients to detect rectal

colonization has been suggested

Difficult to assess impact of surveillance

May be useful in the setting of outbreaks

due to carbapenemase-resistant organisms

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 51: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

Summary

Respect the threat of antimicrobial

resistance

MDRO are seen in NICU as well as in

community

Clinicians need to familiar with treatment

strategies for MDRO

Judicious and appropriate use of antibiotics

THANK YOU

Page 52: Choosing antibiotics in MDRO infections in NICU · Hypomagnesemia, hyponatremia and hypokalemia, have also been reported in neonates receiving colistin therapy. Thomas R et al. The

THANK YOU