What is the mechanism of action of colistin?
Colistin is mainly active against gram-negative organisms. Its mode of action involves inducing changes in the permeability of the cell wall by binding anionic lipopolysaccharide molecules and displacing calcium and magnesium, thus causing cell leakage and death (Jeong et al., 2009).
What is inhaled colistin?
Colistin is a polymyxin antibiotic administered as the prodrug colistimethate. Due to poor pharmacokinetics, administration of colistin intravenously is only recommended for urinary tract infections or as inhalation therapy for multi-drug resistant bacteria.
What is colistin base activity?
Colistin is available in 2 salt forms, colistin sulfate and colistimethate sodium (CMS) [4]. Relative to the sulfate salt, CMS is safer when given parenterally [2]. On administration, CMS is hydrolyzed to colistin, which is the base component that is responsible for antibacterial activity [4].
How does colistin cause nephrotoxicity?
The mechanism of nephrotoxicity is via an increase in tubular epithelial cell membrane permeability, which results in cation, anion and water influx leading to cell swelling and cell lysis. There are also some oxidative and inflammatory pathways that seem to be involved in colistin nephrotoxicity.
How is colistin administered?
Colistin can be administered by aerosol inhalation or by i.m. or i.v. injection following reconstitution with 0.9% sodium chloride injection or sterile water for injection. However, when indicated, colistin can be given via other routes, such as intrathecally.
What is aerosolized colistin used to treat?
Recently, aerosolized colistin was used successfully to treat and prevent pneumonia caused by P aeruginosa in patients with human immunodeficiency syndrome and in patients with nosocomial pneumonia and tracheobronchitis [21-23].
Is colistin concentration dependent?
Colistin displays concentration-dependent killing against susceptible strains of P. aeruginosa, A. baumannii and K. pneumoniae, including MDR strains [21–24].
Does colistin increase creatinine?
Patients who developed nephrotoxicity were older, had more shock, and received excessive daily doses of colistin….Table 2.
| Category | Criteria |
|---|---|
| Risk (R) | Increased creatinine level × 1.5 or GFR decrease >25% |
| Injury (I) | Increased creatinine level × 2 or GFR decrease >50% |
What is resistant to colistin?
Moreover, some species are resistant naturally to colistin, such as Proteus species, Providencia species, Morganella morganii, Pseudomonas mallei, Chromobacterium species, Burkholderia cepacia, Serratia marcescens, Edwardsiella species, Campylobacter, Vibrio cholera, and Brucella, Legionella.
What is Colistimethate sodium used for?
Colistimethate injection is used to treat certain infections caused by bacteria. Colistimethate injection is in a class of medications called antibiotics. It works by killing bacteria. Antibiotics such as colistimethate injection will not work for colds, flu, or other viral infections.