No

Antibiotic, Miscellaneous

Treatment of infections due to sensitive strains of certain gram-negative bacilli which are resistant to other antibacterials or in patients allergic to other antibacterials

B

Hypersensitivity to colistimethate or any component

Use with caution in patients with pre-existing renal disease

1% to 10%: Respiratory arrest, nephrotoxicity, GI upset, vertigo, slurring of speech, urticaria

Other nephrotoxic drugs, neuromuscular blocking agents

Freshly prepare any infusion and use for no longer than 24 hours

Hydrolyzed to colistin, which acts as a cationic detergent which damages the bacterial cytoplasmic membrane causing leaking of intracellular substances and cell death

Distribution: Widely distributed, except for CNS, synovial, pleural, and pericardial fluids

Half-life: 1.5-8 hours; may be as high as 2-3 days in anuric patients

Elimination: Excreted primarily unchanged in urine

Peak: About 2 hours

Children and Adults:

Inhalation: 75 mg in 3 mL NS (4 mL total) via nebulizer twice daily

Dosing interval in renal impairment: Adults:

S_cr 0.7-1.2 mg/dL: 100-125 mg 2-4 times/day

S_cr 1.3-1.5 mg/dL: 75-115 mg twice daily

S_cr 1.6-2.5 mg/dL: 66-150 mg once or twice daily

S_cr 2.6-4 mg/dL: 100-150 mg every 36 hours

No information available to require special precautions

No effects or complications reported

Freshly prepare and use within 24 hours

Powder for injection, lyophilized: 150 mg

Bauldoff GS, Nunley DR, Manzetti JD, et al, "Use of Aerosolized Colistin in Cystic Fibrosis Patients Awaiting Lung Transplantation," Transplantation, 1997, 64(5):748-52.

Conway SP, Pond MN, Watson A, et al, "Intravenous Colistin Sulphomethate in Acute Respiratory Exacerbations in Adult Patients With Cystic Fibrosis," Thorax, 1997, 52(11):987-93.

Jensen T, Pederson SS, Garne S, et al, "Colistin Inhalation Therapy in Cystic Fibrosis Patients with Chronic Pseudomonas aeruginosa Lung Infection," J Antimicrob Chemother, 1987, 19(6):831-8.

Zylberberg H, Vargaftig J, Barbieux C, et al, "Prolonged Efficiency of Secondary Prophylaxis with Colistin Aerosols for Respiratory Infection Due to Pseudomonas aeruginosa in Patients Infected With Human Immunodeficiency Virus," Clin Infect Dis, 1996, 23(3):641-3.