Colistin

Restricted
Restricted

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

$$

Dosing

Adult

5 mg/kg IV x 1, then 5 mg/kg/day IV divided into 2-3 doses, adjusted for renal function and dialysis

75 mg q12h inhaled

Restricted Use

Infectious Diseases consultation required

General Information

Acceptable Uses

  • Management of infections due to multi-drug resistant Enterobactericiae, Acinetobacter, and Pseudomonas on a case-by-case basis.

Unacceptable Uses

  • Infections due to non-MDR pathogens for which alternate therapy, particularly beta-lactam antibiotics, are available

  • Prophylaxis

Common Usage

Severe infectious caused by multidrug-resistant Gram-negative organisms when other antimicrobial options are limited

Drug Monitoring

Laboratory

  • CBC, BMP 2x/ weekly

Clinical

  • Monitor for nephrotoxicity and neuromuscular blockade.

Adverse Effects

  •  Nephrotoxicity in up to 20% of patients

  •  Phlebitis at infusion sites

  •  Neurotoxicity

  •  Inhaled form: Possible bronchospasm, ARDS

Pharmacology

Pregnancy category: C