What is the recommended treatment for Acinetobacter infection with colistin (polymyxin E) in a post-bone marrow transplant (BMT) child?

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Last updated: October 23, 2025View editorial policy

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Colistin Treatment for Acinetobacter Infections in Post-BMT Children

For Acinetobacter infections in post-bone marrow transplant children, colistin (polymyxin E) is recommended with a loading dose of 5 mg/kg colistin base activity (CBA) followed by a maintenance dose of 2.5 mg CBA/kg/day divided every 12 hours, with careful monitoring of renal function. 1, 2

Dosing Recommendations for Pediatric Patients

  • The FDA recommends a loading dose of 0.15 MU/kg (equivalent to 5 mg/kg CBA) followed by a maintenance dose of 0.075 MU/kg every 12 hours (equivalent to 2.5-5 mg CBA/kg/day) 2, 1
  • Dose adjustment is required based on renal function, with close monitoring throughout treatment 1, 2
  • For critically ill children, higher dosing may be necessary when the MIC of the infecting Acinetobacter strain is ≥1 mg/L or when the patient has augmented renal clearance 1
  • Administration should be via slow intravenous infusion over 3-5 minutes for direct intermittent administration, or as a continuous infusion over 22-23 hours 2

Monotherapy vs. Combination Therapy

  • For carbapenem-resistant Acinetobacter baumannii (CRAB) infections, colistin-based therapy is recommended as the backbone of treatment 1
  • Combination therapy with colistin plus a carbapenem has shown the best outcomes in network meta-analyses, with a higher survival rate compared to colistin monotherapy 1, 3
  • For bloodstream infections, colistin with or without a carbapenem is recommended for a duration of 10-14 days 1
  • For pneumonia, colistin with or without a carbapenem plus adjunctive inhaled colistin is recommended for at least 7 days 1

Site-Specific Considerations

  • For central nervous system infections (meningitis/ventriculitis), which can occur in post-BMT patients, combination therapy with intravenous and intraventricular colistin may be necessary for effective treatment 4, 5
  • For pneumonia, consider adding adjunctive inhaled colistin at a dose of 1.25-5 MIU/day in 2-3 divided doses 1
  • For bloodstream infections, a longer treatment duration of 10-14 days is recommended 1

Alternative Treatment Options

  • If the Acinetobacter strain is susceptible to sulbactam, this may be considered as an alternative to colistin due to its better safety profile (nephrotoxicity rates of 15.3% for sulbactam vs. 33% for colistin) 6, 3
  • For strains with tigecycline MIC ≤1 mg/L, tigecycline may be considered as part of combination therapy, but should not be used as monotherapy 1, 3

Monitoring and Adverse Effects

  • Renal function should be closely monitored during colistin treatment, as nephrotoxicity is a major concern and is associated with clinical failure and mortality 1, 6
  • Acute kidney injury during colistin treatment is one of the most important factors related to clinical failure and mortality 1
  • There is no current consensus regarding frequency of dose adjustment and timing of withdrawal of therapy in the presence of acute kidney injury 1

Common Pitfalls and Considerations

  • Underdosing colistin in pediatric patients with good renal function or when treating strains with MIC ≥1 mg/L may lead to treatment failure 1, 6
  • Heteroresistance to colistin is a concern, with rates varying widely in clinical isolates 6, 7
  • Previous use of colistin might be a risk factor for higher rates of heteroresistance 6
  • Not considering local resistance patterns and MIC values when selecting therapy 6, 8
  • Failure to adjust dosing based on renal function can increase toxicity risk 1, 2

Treatment Algorithm

  1. Obtain cultures and susceptibility testing before initiating therapy 8
  2. For confirmed Acinetobacter infection in a post-BMT child:
    • Start with colistin loading dose of 5 mg/kg CBA 1, 2
    • Follow with maintenance dose of 2.5 mg CBA/kg/day divided every 12 hours 1, 2
    • Consider combination with a carbapenem if MIC ≤32 mg/L 1
  3. Adjust dose based on renal function and monitor renal parameters closely 1, 2
  4. For specific sites of infection, consider:
    • Adding inhaled colistin for pneumonia 1
    • Intraventricular colistin for CNS infections 4, 5
  5. Continue treatment for at least 7 days for pneumonia and 10-14 days for bloodstream infections 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Treatment of Multidrug-Resistant Acinetobacter Infections

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Treatment of Acinetobacter Infections

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Treatment of Acinetobacter baumannii Infections

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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