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Colistin: an antibiotic and its role in multiresistant Gram-negative infections
1Department of Clinical Pathology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Abstract:
Increasing number of infection cases caused by multiresistant Gram-negative bacteria or multidrug resistant organism (MDRO) has become a major problem worldwide since there have been a lot of resistance to many classes of antibiotics. Mutant isolates such as fluoroquinolone-resistant and -lactamase-resistant bacteria have been commonly found, particularly in intensive care unit (ICU). During the last two decades, there has been no study of developing antibiotics in search of discovering new type of antibiotics; meanwhile, the resistance of Gram-negative bacteria or MDRO to antibiotics is increasing. Colistin or polymyxin E is an old antibiotic, which has been used since 1959 for treating infection caused by Gram-negative MDRO. It was revealed that colistin has side effects of nephrotoxicity and neurotoxicity; therefore, the use of this antibiotic was stopped and it was replaced by other antibiotics which were effective and were considered safer at that time. There is an increasing number of infections with multi-resistant Gram-negative (MDRO) against the available antibiotics and the availability of alternative antibiotics has not been satisfying; therefore, microbiologists are searching back to the old option, which has been proven to be effective against multi-resistant Gram-negative bacteria, the old antibiotic that has been long forgotten, i.e. colistin, as an alternative treatment against Gram-negative MDRO. It is expected that colistin may have essential and reliable role as future antibiotics for treatment of multi-resistant Gram-negative infections and as an alternative of antibiotics that have been available so far.
Insights
Multidrug-resistant Gram-negative infections are a growing global threat. Researchers are revisiting colistin, an older antibiotic, as a potential solution due to limited alternatives for treating these challenging infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Rising global incidence of infections caused by multidrug-resistant Gram-negative bacteria (MDRO).
- Limited development of new antibiotics over the past two decades, exacerbating the resistance crisis.
- Common occurrence of fluoroquinolone-resistant and beta-lactamase-resistant bacterial isolates, particularly in intensive care units (ICUs).
Purpose of the Study:
- To re-evaluate the potential of colistin as a viable treatment option for multidrug-resistant Gram-negative infections.
- To address the unmet need for effective antibiotics against increasingly resistant bacterial strains.
- To explore colistin's role as an alternative therapeutic agent in the face of antibiotic resistance.
Main Methods:
- Review of historical antibiotic usage and efficacy data.
- Analysis of current trends in antibiotic resistance patterns.
- Assessment of colistin's effectiveness against multidrug-resistant Gram-negative bacteria.
Main Results:
- Colistin, an older antibiotic, demonstrates efficacy against multidrug-resistant Gram-negative bacteria.
- Despite historical concerns regarding nephrotoxicity and neurotoxicity, colistin is being reconsidered due to a lack of effective alternatives.
- The increasing prevalence of MDRO infections necessitates the exploration of previously used antibiotics.
Conclusions:
- Colistin shows promise as a crucial and reliable antibiotic for treating multidrug-resistant Gram-negative infections.
- It can serve as a valuable alternative to currently available, yet often unsatisfactory, antibiotic options.
- Further research and clinical application of colistin are warranted to combat the growing threat of antibiotic resistance.
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