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Published on: April 4, 2022
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[The challenge in colistin dosing: Updating available recommendations]
Ruth Rosales1, Loreto Rojas2, Francisco Zamora1
1Complejo Asistencial Barros Luco Trudeau, Santiago, Chile.
Summary
Colistin, an important antibiotic for multidrug-resistant infections, requires updated dosing and pharmacokinetic data due to safety concerns and product variations. This review provides current recommendations for its effective and safe clinical use.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Polymyxins, including colistin, have been used since the 1960s for multidrug-resistant bacterial infections.
- Adverse effects have historically limited colistin use, reserving it for severe infections.
- Recent clinical data and literature question existing product information, necessitating updated guidance.
Purpose of the Study:
- To review and update recommendations for colistin use, focusing on dosage, pharmacokinetics, and pharmacodynamics (PK/PD).
- To address safety and efficacy concerns associated with colistin.
- To provide current pharmaceutical information and recommended treatment schemes.
Main Methods:
- Review of recent clinical experience and published medical literature.
- Analysis of data commissioned by the European Medicines Agency (EMA).
- Evaluation of pharmacokinetic and stability data, and available pharmaceutical forms.
Main Results:
- Identified critical safety and efficacy aspects of colistin.
- Highlighted advances in pharmacokinetic and stability research.
- Summarized current recommended dosing schemes from health agencies and experts.
Conclusions:
- Updated recommendations for colistin dosage, pharmacokinetics, and PK/PD are crucial.
- Addressing product concentration differences is vital to prevent administration errors.
- This review provides essential information for the safe and effective clinical application of colistin.
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