Colistin neurotoxicity: revisited

Area of Science:

• Pharmacology
• Infectious Diseases
• Critical Care Medicine

Background:

• Polymyxins, including colistin, have regained importance due to rising multidrug-resistant Gram-negative bacterial infections.
• Renewed use necessitates a thorough understanding of their toxicity profile.

Observation:

• A postoperative patient developed burst abdomen and was treated with colistin for a Pseudomonas infection.
• The patient subsequently experienced respiratory depression and encephalopathy.

Findings:

• Discontinuation of colistin led to prompt recovery of neurological and respiratory function.
• This suggests a direct link between colistin administration and the observed adverse events.

Implications:

• Clinicians must carefully weigh the benefits against the risks of colistin, especially in vulnerable patients.
• Monitoring for neurotoxicity and respiratory depression is crucial during colistin therapy.
• Further research into optimizing polymyxin dosing and managing toxicity is warranted.