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Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections

Jian Li1, Roger L Nation, John D Turnidge

  • 1Facility for Anti-infective Drug Development and Innovation, Victorian College of Pharmacy, Monash University, Parkville, Victoria, Australia. Jian.Li@vcp.monash.edu.au

The Lancet. Infectious Diseases
|August 26, 2006
PubMed

Insights

Multidrug resistance in Gram-negative bacteria necessitates reassessing colistin, an older antibiotic. Rational use of colistin is crucial alongside new drug discovery to combat bacterial resistance.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Rising multidrug resistance in Gram-negative bacteria (Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae) poses a significant clinical challenge.
  • Limited effective therapeutic options necessitate a re-evaluation of colistin, a polymyxin antibiotic with a long history of use.

Purpose of the Study:

  • To summarize recent advancements in understanding colistin's chemistry, pharmacokinetics, and pharmacodynamics.
  • To review the interplay of these factors and their impact on colistin's clinical application.
  • To evaluate current clinical findings regarding colistin's efficacy, resistance, toxicity, and combination therapy.

Main Methods:

  • Review of recent scientific literature on colistin.
  • Analysis of pharmacokinetic and pharmacodynamic data.
  • Evaluation of clinical trial results and case studies.

Main Results:

  • Progress in understanding colistin's complex properties and their clinical implications.
  • Insights into emerging resistance patterns and potential toxicities associated with colistin use.
  • Evidence supporting the role of colistin in combination therapies against resistant Gram-negative infections.

Conclusions:

  • Colistin remains a vital therapeutic option for multidrug-resistant Gram-negative infections.
  • A rational approach to colistin's use, considering its properties and clinical data, is essential.
  • Combating antibiotic resistance requires both new drug development and optimized use of existing agents like colistin.

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