Antimicrobials
Colistin

Colistin

Low
N/A

Spectrum of Activity

Dosing

General Information

Pregnancy:

  • No data in human pregnancy.
  • Limited data in animal models do not suggest teratogenicity.

Breastfeeding:

  • Limited data indicate that colistin is minimally excreted into breastmilk following intramuscular administration of colistimethate.
  • Because colistin is poorly absorbed orally, it is unlikely to be absorbed in appreciable amounts by the infant or adversely affect the breastfed infant.
  • However, no studies have evaluated serum levels or adverse effects in breastfed infants whose mothers were receiving colistimethate.
  • Breastfeeding is acceptable with the use of inhaled colistin or colistimethate.

Infections caused by multi-drug resistant gram negative organisms including carbapenemase-producing organisms.

Consultation with infectious disease is strongly recommended.

Serum creatinine, urine output

  • Nephrotoxicity
  • Neurotoxicity
  • Muscle weakness
  • Dizziness, paresthesias, slurred speech, vertigo
  • Concomitant use of nephrotoxic agents.
  • Can enhance the neuromuscular-blocking effect of neuromuscular-blocking agents.

Avoid in myasthenia gravis.

ALL DOSES FOR COLISTIN MUST BE EXPRESSED IN COLISTIN BASE. Colistin Base Activity (CBA) 1 mg is defined to be equivalent to colistimethate sodium (CMS) 30,000 units which is equivalent to ~2.4 mg CMS.

Antimicrobial Class: Colistimethate (or the sodium salt [colistimethate sodium]) is the inactive prodrug that is hydrolyzed to colistin, which acts as a cationic detergent and damages the bacterial cytoplasmic membrane causing leaking of intracellular substances and cell death

ALL DOSES FOR COLISTIN MUST BE EXPRESSED IN COLISTIN BASE. Colistin Base Activity (CBA) 1 mg is defined to be equivalent to colistimethate sodium (CMS) 30,000 units which is equivalent to ~2.4 mg CMS.