Colistin: understanding and applying recent pharmacokinetic advances.

Abstract:

:Colistin, the most widely used polymyxin antibiotic, was originally introduced in the late 1950s before the establishment of the present-day drug approval process. Originally shelved due to toxicity concerns, colistin, in the form of its inactive prodrug colistin methanesulfonate, has undergone a renaissance in the past 15 years. Unfortunately, this is not because of an improved adverse-effect profile but because colistin is among the only remaining antibiotics with activity against multidrug-resistant gram-negative bacilli. Pharmacokinetic and pharmacodynamic data are limited to guide the appropriate use of colistin; however, important advances have occurred over the past 5 years. Since its reintroduction, published reports regarding colistin have produced discordant results in terms of both efficacy and safety. Because the efficacy and toxicity of colistin are dose dependent, the impact of discordant dosing recommendations cannot be understated. This review highlights the issues leading to differing and often conflicting dosing recommendations, reviews the recent pharmacokinetic advances, and provides recommendations for the optimal use of colistin.

journal_name

Pharmacotherapy

journal_title

Pharmacotherapy

authors

Ortwine JK,Kaye KS,Li J,Pogue JM

doi

10.1002/phar.1484

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

11-6

issue

1

eissn

0277-0008

issn

1875-9114

journal_volume

35

pub_type

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