Colistin, also known as polymyxin E, is an antibiotic medication used as a last-resort treatment for multidrug-resistant Gram-negative infections including pneumonia.[7][8] These may involve bacteria such as Pseudomonas aeruginosa, Klebsiella pneumoniae, or Acinetobacter.[9] It comes in two forms: colistimethate sodium can be injected into a vein, injected into a muscle, or inhaled, and colistin sulfate is mainly applied to the skin or taken by mouth.[10] Colistimethate sodium[11] is a prodrug; it is produced by the reaction of colistin with formaldehyde and sodium bisulfite, which leads to the addition of a sulfomethyl group to the primary amines of colistin. Colistimethate sodium is less toxic than colistin when administered parenterally. In aqueous solutions it undergoes hydrolysis to form a complex mixture of partially sulfomethylated derivatives, as well as colistin. Resistance to colistin began to appear as of 2015.[12]
Common side effects of the injectable form include kidney problems and neurological problems.[8] Other serious side effects may include anaphylaxis, muscle weakness, and Clostridium difficile-associated diarrhea.[8] The inhaled form may result in constriction of the bronchioles.[8] It is unclear if use during pregnancy is safe for the fetus.[13] Colistin is in the polymyxin class of medications.[8] It works by breaking down the cytoplasmic membrane, which generally results in bacterial cell death.[8]
Colistin was discovered in 1947 and colistimethate sodium was approved for medical use in the United States in 1970.[9][8] It is on the World Health Organization's List of Essential Medicines.[14] The World Health Organization classifies colistin as critically important for human medicine.[15] It is available as a generic medication.[16] It is derived from bacteria of the genus Paenibacillus.[10]
^"Drug Product Database". Health Canada. 25 April 2012. Retrieved 13 January 2022.
^"Colobreathe 1,662,500 IU inhalation powder, Hard Capsules – Summary of Product Characteristics (SmPC)". (emc). Retrieved 16 November 2020.
^"Colomycin 1 million International Units (IU) Powder for solution for injection, infusion or inhalation – Summary of Product Characteristics (SmPC)". (emc). 27 May 2020. Retrieved 16 November 2020.
^"Promixin 1 million International Units (IU) Powder for Nebuliser Solution – Summary of Product Characteristics (SmPC)". (emc). 23 September 2020. Retrieved 16 November 2020.
^"Coly-Mycin M- colistimethate injection". DailyMed. 3 December 2018. Retrieved 16 November 2020.
^"Colobreathe EPAR". European Medicines Agency. 17 September 2018. Retrieved 16 November 2020.
^Pogue JM, Ortwine JK, Kaye KS (April 2017). "Clinical considerations for optimal use of the polymyxins: A focus on agent selection and dosing". Clinical Microbiology and Infection. 23 (4): 229–233. doi:10.1016/j.cmi.2017.02.023. PMID 28238870.
^ abcdefg"Colistimethate Sodium Monograph for Professionals". Drugs.com. Retrieved 6 November 2019.
^ abFalagas ME, Grammatikos AP, Michalopoulos A (October 2008). "Potential of old-generation antibiotics to address current need for new antibiotics". Expert Review of Anti-Infective Therapy. 6 (5): 593–600. doi:10.1586/14787210.6.5.593. PMID 18847400. S2CID 13158593.
^ abBennett JE, Dolin R, Blaser MJ, Mandell GL (2009). Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases E-Book. Elsevier Health Sciences. p. 469. ISBN 9781437720600.
^Bergen PJ, Li J, Rayner CR, Nation RL (June 2006). "Colistin methanesulfonate is an inactive prodrug of colistin against Pseudomonas aeruginosa". Antimicrobial Agents and Chemotherapy. 50 (6): 1953–1958. doi:10.1128/AAC.00035-06. PMC 1479097. PMID 16723551.
^Hasman H, Hammerum AM, Hansen F, Hendriksen RS, Olesen B, Agersø Y, et al. (2015-12-10). "Detection of mcr-1 encoding plasmid-mediated colistin-resistant Escherichia coli isolates from human bloodstream infection and imported chicken meat, Denmark 2015". Euro Surveillance. 20 (49): 30085. doi:10.2807/1560-7917.ES.2015.20.49.30085. PMID 26676364.
^"Colistimethate (Coly Mycin M) Use During Pregnancy". Drugs.com. Retrieved 11 November 2019.
^World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^World Health Organization (2019). Critically important antimicrobials for human medicine (6th revision ed.). Geneva: World Health Organization. hdl:10665/312266. ISBN 9789241515528.
^British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 547. ISBN 9780857113382.
Colistin, also known as polymyxin E, is an antibiotic medication used as a last-resort treatment for multidrug-resistant Gram-negative infections including...
Polymyxins are antibiotics. Polymyxins B and E (also known as colistin) are used in the treatment of Gram-negative bacterial infections. They work mostly...
digestive problems. Sulfonamides dissolved in drinking water may be used. Colistin can be an effective antibiotic. Roach, N.; Kennerley, R. (2016). "Chinchilla...
countries. China once used colistin (an antibiotic) as growth promoter (subtherapeutic antibiotic use) but discovered a colistin-resistant form of E. coli...
agar; it also grows on HBT agar. A selective medium for G. vaginalis is colistin-oxolinic acid blood agar. G. vaginalis is a facultatively anaerobic Gram-variable...
oxidizer. Most strains do not grow on colistin nalidixic acid agar because, although they are resistant to colistin, they are susceptible to quinolones...
pharmacologically related group of polypeptide antibiotic compounds including colistin, polymyxin B, and bacitracin. There is no cross-resistance to these three...
gram-negative pathogens in the ICU have invoked the re-emergence of colistin. However, colistin-resistant strains of K. pneumoniae have been reported in ICUs...
polypeptide chains. Examples of this class include actinomycin, bacitracin, colistin, and polymyxin B. Actinomycin-D has found use in cancer chemotherapy. Most...
example in bacitracin; the carboxyl end and a side chain, for example in colistin; or two side chains or more complicated arrangements, for example in alpha-amanitin...
fall back on polymyxins, particularly colistin although tetracyclines have shown promise in MDR A. baumannii. Colistin is considered a drug of last resort...
an E. coli "superbug" was identified in the United States resistant to colistin, "the last line of defence" antibiotic. In recent years, even anaerobic...
meropenem for meningitis caused by Acinetobacter, as an adjunct to imipenem or colistin for neonatal meningitis caused by Streptococcus agalactiae or Listeria...
Resistance or reduced susceptibility to several antibiotics, such as colistin sulphate, clindamycin and kanamycin A or penicillin has been reported....
vancomycin, colistin, nystatin and trimethoprim, to suppress the accompanying flora. Vancomycin is inhibitory for gram-positive bacteria. Colistin inhibits...
two (4%) were resistant to all drugs tested. One antimicrobial agent, colistin (polymyxin E), has been used to treat infections with multidrug-resistant...
Frijlink HW, Heijerman HG (March 2004). "Effect of nebulized colistin sulphate and colistin sulphomethate on lung function in patients with cystic fibrosis:...
for antibiotics with low volume distribution (vancomycin, teicoplanin, colistin), a loading dose is required to achieve an adequate therapeutic level to...
sensitive to vancomycin, erythromycin and ampicillin, but resistant to colistin. These organisms are found in the human vagina, particularly in association...
second-generation cephalosporins, macrolides, lincosamides, fosfomycin, colistin, and polymyxin B. The emergence of highly resistant strains of M. morganii...
Enterobacteriaceae has led to a renaissance of the use of antibiotics such as colistin, which was discovered in the 1950s but rarely used until recently due to...
strains was being treated with a cocktail of Azithromycin, Rifampicin, and Colistin for 4 months without results and overall rapidly declining health. Because...
cephalosporins, glycopeptides, macrolides and ketolides, polymyxins including colistin, and quinolones including fluoroqinolones.[citation needed] The European...
ceftolozane-tazobactam can also be effective. BCC intrinsically resistant to colistin and usually resistant to aminoglycosides. In people with cystic fibrosis...
Global Information
(what is this?) (verify)