Colistin

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

Spectrum Of Activity

Dosing

Consult Infectious Disease

2.5-5 mg/kg/day IV divided into 2-4 doses

General Information

Acceptable Uses

  • Management of multi-drug resistant infections caused by Enterobactericiae, Acinetobacter, and Pseudomonas (on a case by case basis)

Unacceptable Uses

  • Mangement of infections due to non-multidrug resistant pathogens

  • Prophylaxis

Common Usage

Severe infections caused by multidrug-resistant gram-negative organisms when other antimicrobial options are limited.

Drug Monitoring

Lab

  • periodic CBC and BMP

Clinical

  • Monitor for nephrotoxicity

  • monitor for neuromuscular blockade

Adverse Effects

  • Phlebitis at infusion site

  • Neurotoxicity

  • Nephrotoxicity in up to 20% of patients

  • Inhaled form: bronchospasm

Pharmacology

Pregnancy category: C

Average serum half life: 2-3 hr

Route of Elimination: Primarily urine