{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T06:01:39Z","timestamp":1789970499528,"version":"4.0.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intravenous polymyxins remain salvage agents for resistant Gram-negative infections in children, but pediatric evidence on clinical outcomes and toxicity is fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Wanfang Data, SinoMed, and VIP from inception to 31 January 2025. Eligible studies reported intravenous polymyxin-containing therapy in hospitalized pediatric patients with documented or suspected resistant Gram-negative infections. Random-effects single-arm meta-analyses were used to estimate pooled outcome proportions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-four studies comprising 1,152 reported patients or treatment units were included, most of which were single-arm observational studies. The pooled proportions were 22% [95% confidence interval (CI) 16%\u201327%] for all-cause mortality, 14% (95% CI 11%\u201317%) for infection-related mortality, 65% (95% CI 58%\u201372%) for clinical improvement, 13% (95% CI 9%\u201317%) for overall adverse events, and 10% (95% CI 7%\u201314%) for nephrotoxicity. Neurotoxicity and hepatotoxicity were infrequently reported. Clinical setting, dosing, outcome definitions, and units of analysis were heterogeneous.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The available evidence describes outcomes observed during intravenous polymyxin-containing therapy in hospitalized children but does not establish comparative efficacy or causality for adverse events. Prospective multicenter pediatric studies using standardized dosing, outcome, and safety definitions are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1928217","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:35:34Z","timestamp":1789968934000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes and adverse events associated with intravenous polymyxin-containing therapy in hospitalized children with resistant Gram-negative infections: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Huilian","family":"Chen","sequence":"first","affiliation":[{"name":"Pediatric Department, West China Second University Hospital, Sichuan University","place":["Chengdu, China"]},{"name":"NHC Key Laboratory of Chronobiology, Sichuan University","place":["Chengdu, 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuanghong","family":"Luo","sequence":"additional","affiliation":[{"name":"Pediatric Department, West China Second University Hospital, Sichuan University","place":["Chengdu, China"]},{"name":"NHC Key Laboratory of Chronobiology, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Qiao","sequence":"additional","affiliation":[{"name":"Pediatric Department, West China Second University Hospital, Sichuan University","place":["Chengdu, China"]},{"name":"NHC Key Laboratory of Chronobiology, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/S1473-3099(06)70580-1","article-title":"Colistin: the re-emerging antibiotic for multidrug-resistant 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