Colistin Dosing in Continuous Renal Replacement Therapy
Colistin is a multicomponent polypeptide antibiotic produced by strains of the Paenibacillus polymyxa bacteria . 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. . Resistance is rare and mediated by plasmid transfer between bacterial strains....
- 8.Plachouras D, Karvanen M, Friberg LE et al (2009) Population pharmacokinetic analysis of colistin methanesulfonate and colistin after intravenous administration in critically ill patients with infections caused by gram-negative bacteria. Antimicrob Agents Chemother 53:3430–3436CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Dudhani RV, Li J, Nation RL (2009) Plasma binding of colistin involves multiple proteins and is concentration dependent: potential clinical implications. Abstracts of the forty-ninth Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, p 41Google Scholar
- 20.Honore PM, Jacobs R, Lochy S et al (2013) Acute respiratory muscle weakness and apnea in a critically ill patient induced by colistin neurotoxicity: key potential role of hemoadsorption elimination during continuous venovenous hemofiltration. Int J Nephrol Renovasc Dis 6:107–111CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Verdoodt A, Honore PM, Jacobs R, Van Gorp V, Hubloue I, Spapen HD (2017) High-dose colistin combined with continuous veno-venous haemofiltration for treatment of multidrug-resistant Gram-negative infection in critically ill patients. Intensive Care Med Exp 5(Suppl 2):44-0986 (abst)Google Scholar