Colistin Dosing in Continuous Renal Replacement Therapy

  • P. M. HonoreEmail author
  • M. L. N. G. Malbrain
  • H. D. Spapen
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)


Colistin is a multicomponent polypeptide antibiotic produced by strains of the Paenibacillus polymyxa bacteria [1]. It was abandoned from clinical use in the 1970s because of significant renal and neurological toxicity. Currently, colistin is increasingly proposed as a last resort treatment for severe multidrug‐resistant (MDR) Gram‐negative bacterial infections, particularly in the intensive care unit (ICU). Colistin has a relatively narrow spectrum but is very effective against Enterobacteriaceae (Escherichia coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., Salmonella spp. and Shigella spp., including extended spectrum beta‐lactamase [ESBL], Klebsiella pneumoniae carbapenemase [KPC], verona integron‐encoded metallo‐β‐lactamase [VIM] and New Delhi metallo [NDM]‐1 producers), and MDR Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia and Aeromonas spp. [2]. Resistance is rare and mediated by plasmid transfer between bacterial strains....


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • P. M. Honore
    • 1
    Email author
  • M. L. N. G. Malbrain
    • 1
  • H. D. Spapen
    • 1
  1. 1.Department of Intensive Care, Universitair Ziekenhuis BrusselVrije Universiteit Brussel (VUB)BrusselsBelgium

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