Colistin

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

$24.98

Dosing

Most commonly prescribed in terms of mg of Colistin base activity

Pharmacy consultation recommended to ensure appropriateness of dose

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

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

Major Interactions

Additive toxicity with other nephrotoxic drugs

Additional Information

IV Administration
Dilute in 50-100 mL D5W or NS and administer over 30 min.

EH Prescribing Restrictions
- None
- Pharmacist review of therapy

Community IV Formulary (Metro Area)
YES

Pharmacology

Pregnancy category: C

Average serum half life: 2-3 hr

Route of Elimination: Primarily urine