Related Experiment Video
Updated: May 16, 2026
11:17
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Colistin in critically ill patients
M Boisson1, N Gregoire, W Couet
1Inserm U1070, University of Poitiers, Poitiers, France. matthieu.boisson@univ-poitiers.fr
Minerva Anestesiologica
|December 18, 2012
Summary
Colistin, an old antibiotic, treats resistant infections. New HPLC assays improve understanding of its pharmacokinetics, aiding critical care.
Area of Science:
- Pharmacology
- Infectious Diseases
- Critical Care Medicine
Background:
- Colistin is a vital antibiotic for multidrug-resistant Gram-negative infections.
- Colistin is administered as an inactive prodrug, colistin methanesulfonate (CMS), which hydrolyzes to active colistin.
- Traditional pharmacokinetic studies using biological assays are unreliable due to CMS hydrolysis.
Purpose of the Study:
- To provide an updated review of colistin's pharmacodynamics, pharmacokinetics, safety, and clinical applications.
- To focus on data relevant for treating critically ill patients with colistin.
- To highlight the impact of new analytical methods on understanding colistin's behavior in vivo.
Main Methods:
- Review of recent literature on colistin.
- Emphasis on studies utilizing high-performance liquid chromatography (HPLC) for accurate CMS and colistin quantification.
- Analysis of pharmacokinetic and pharmacodynamic data across diverse patient populations.
Main Results:
- High-performance liquid chromatography (HPLC) enables accurate measurement of CMS and colistin.
- New pharmacokinetic data are available for various populations, including critically ill patients.
- Updated information on colistin's efficacy, safety, and dosing considerations.
Conclusions:
- Accurate pharmacokinetic data derived from HPLC assays are crucial for optimizing colistin therapy.
- This updated review provides essential information for clinicians managing infections caused by multidrug-resistant Gram-negative bacteria.
- Special attention is given to the application of colistin in critical care settings.
More Related Videos
Related Concept Videos
01:25Clinical Significance of Antibiotic Resistance
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
01:28Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:28Inhibitors of Bacterial DNA Synthesis
Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These antibiotics are selectively...
01:30Cleaning, Sterilization, and Disinfection
Cleaning, disinfection, and sterilization are the methods that help to break the infection chain and prevent disease.
Cleaning
The cleaning process usually involves using water with detergents or enzymatic cleaner and removing foreign material from objects and surfaces, including organic material such as body fluids or inorganic material like soil. Cleaning is performed before high-level disinfection and sterilization because foreign materials on the cover of the devices interfere with process...
Cleaning
The cleaning process usually involves using water with detergents or enzymatic cleaner and removing foreign material from objects and surfaces, including organic material such as body fluids or inorganic material like soil. Cleaning is performed before high-level disinfection and sterilization because foreign materials on the cover of the devices interfere with process...
01:20Cholecystitis
Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...