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colistin

A mixture of cyclic polypeptide antibiotics derived from a strain of Bacillus polymyxa. It consists primarily of colistin A with small amounts of colistin B. Indications: 1) drug-resistant, gram-negative nosocomial infection - Acinetobacter baumannii [2] - carbapenem-resistant bacteria [7] 2) ventilator-associated pneumonia [2,3] Dosage: - 5 mg/kg/day IV [4] Monitor: - renal function [4] Adverse effects: 1) nephrotoxicity (50%) generally reversible [4] 2) neurotoxicity 3) neruomuscular blockade Laboratory: - colistin resistance gene Notes: - report of colistin-resistant E coli in the U.S. - organism isolated from urine [7,8] - organism isolated from feces of child returning from Caribbean [9] - organisms not resistant to carbapenem [7] - gene for colistin-resistance found on a plasmid [6] - no information on patient's ultimate fate or whether the patient was symptomatic from E coli found - transmission to contacts uncommon [10] - mcr-1 testing of all Enterobacteriaceae isolates with a colistin or polymyxin B minimum inhibitory concentration of 4 ug/mL or higher [10] - testing can be performed through the CDC

Interactions

drug interactions

Specific

colistimethate (Coly-Mycin M) colistin A colistin B

General

other antibiotic

Properties

Database Correlations

PUBCHEM cid=5311054

References

  1. Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999
  2. Journal Watch 23(13):104, 2003 Garnacho-Montero J et al Treatment of multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia (VAP) with intravenous colistin: a comparison with imipenem-susceptible VAP. Clin Inect Dis 36:1111, 2003 PMID: 12715304
  3. Florescu DF et al. What is the efficacy and safety of colistin for the treatment of ventilator-associated pneumonia? A systematic review and meta-regression. PMID: 22322268 - Falagas ME and Rafailidis PI. Colistin in ventilator-associated pneumonia. Clin Infect Dis 2012 Mar 1; 54:681. PMID: 22322269
  4. Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018, 2021.
  5. Falagas ME, Kasiakou SK. Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis. 2005 May 1;40(9):1333-41. Review. PMID: 15825037 Free Article
  6. Rosen M Bacteria resistant to last-resort antibiotic appears in U.S. Science News. May 27, 2016 https://www.sciencenews.org/article/bacteria-resistant-last-resort-antibiotic-appears-us - McGann P et al. Escherichia coli harboring mcr-1and bla(CTX-M) on a novel IncF plasmid: First report of mcr-1in the USA. Antimicrobial Agents and Chemotherapy. May 26, 2016 http://aac.asm.org/content/early/2016/05/25/AAC.01103-16
  7. Orciari Herman A, Fairchild DG Bacteria Resistant to Last-Resort Antibiotic Discovered in U.S. Physician's First Watch, May 31, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
  8. Kline KE, Shover J, Kallen AJ, Lonsway DR, Watkins S, Miller JR. Investigation of First Identified mcr-1 Gene in an Isolate from a U.S. Patient - Pennsylvania, 2016. MMWR Morb Mortal Wkly Rep. ePub: 9 September 2016 http://www.cdc.gov/mmwr/volumes/65/wr/mm6536e2.htm
  9. Vasquez AM, Montero N, Laughlin M, et al. Investigation of Escherichia coli Harboring the mcr-1 Resistance Gene - Connecticut, 2016. MMWR Morb Mortal Wkly Rep. ePub: 9 September 2016 http://www.cdc.gov/mmwr/volumes/65/wr/mm6536e3.htm
  10. Orciari Herman A, Sadoughi S, Sofair A. CDC: E. Coli Resistant to Last-Resort Antibiotic Again Found in U.S., No Transmission Seen Physician's First Watch, Sept 12, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org

Component-of

bacitracin/colistin/cortisol colistin/cortisol/neomycin (Coly-Mycin S) colistin/cortisol/neomycin/thonzonium bromide