Colistin-induced myasthenic syndrome in a patient with end-stage renal disease

Area of Science:

• Infectious Diseases
• Pharmacology
• Neurology

Background:

• The rise of multidrug-resistant (MDR) bacteria necessitates the re-evaluation of older antibiotics.
• Colistin, previously avoided due to toxicity, is now a critical option for MDR bacterial infections.
• Novel broad-spectrum antibiotics are lacking in the current research pipeline.

Observation:

• A case report details a patient treated with colistin for MDR Klebsiella-related urosepsis.
• The patient developed a rare neuromuscular complication resembling myasthenic syndrome.
• This highlights a potential adverse effect of colistin therapy.

Findings:

• Colistin administration led to the development of a myasthenic syndrome-like condition.
• This rare complication occurred in the context of treating a serious MDR infection.
• The patient's presentation suggests a link between colistin and neuromuscular dysfunction.

Implications:

• Clinicians should be aware of rare neuromuscular toxicities associated with colistin.
• Further research is needed to understand the mechanisms of colistin-induced neuromuscular complications.
• This case underscores the complex risk-benefit balance when using older antibiotics for MDR infections.