Action and Spectrum

Actions and spectrum: 

colistin is an antibiotic that belongs to the class of polymyxins. It is used to treat infections which are caused by Gram-ve bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae.

colistin is a last-resort antibiotic and is typically used only when other antibiotics are ineffective or not available. It acts by binding to the bacterial cell membrane and disrupting its structure, leading to bacterial death. 

Drug Interaction

Adverse Reaction

Frequency defined 

<1% 

Nephrotoxicity 

Respiratory tract paralysis 

Neurotoxicity 

Acute respiratory failure   

1-10% 

Paresthesia 

Tingling of tongue and extremities 

Dizziness  

Frequency not defined 

Vertigo 

Anaphylaxis 

Slurred speech 

Seizures 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

colistin is contraindicated in patients with a history of hypersensitivity or allergic reaction to colistin or polymyxins. It is also contraindicated in patients with pre-existing renal dysfunction or neurological disorders.  

Caution: 

• Neurotoxicity: colistin may cause neurotoxicity (damage to the nervous system). Patients with pre-existing neurological conditions may be more susceptible to this adverse effect. 
• Nephrotoxicity: colistin may cause nephrotoxicity (kidney damage). Patients with pre-existing kidney problems, those receiving other nephrotoxic drugs, or those receiving colistin at higher doses or for longer periods may be at increased risk. 
• Respiratory problems: colistin may cause bronchospasm (narrowing of the airways in the lungs) and may worsen respiratory distress in patients with pre-existing respiratory problems. 
• Allergic reactions: colistin may cause hypersensitivity reactions (allergic reactions) in some patients. 
• pregnancy and lactation: The safety of colistin use during pregnancy & lactation is not established. Therefore, the use of colistin in pregnant and lactating women should be carefully considered. 
• Use in pediatric patients: colistin may be associated with a higher risk of neurotoxicity and nephrotoxicity in pediatric patients, especially those with pre-existing renal or neurological conditions. Therefore, the use of colistin in pediatric patients should be carefully considered.

Comorbidities: 

colistin is an antibiotic and is typically used to treat bacterial infections which are caused by gram-negative bacteria. It is usually reserved for infections that are resistant to other antibiotics. 

Patients with comorbidities such as kidney disease or neuromuscular disorders may need dosage adjustments or close monitoring when taking colistin. colistin can cause kidney damage, and patients with kidney disease may be at increased risk. 

Pregnancy / Lactation

Pregnancy consideration: Pregnancy Category: C 

Lactation: It is not known if colistin is excreted in human milk  

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: There is no evidence of risk to the fetus found in animal reproduction studies and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women. 
• Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh risks over benefits These category drugs should be prohibited for pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

colistin is an antibiotic that belongs to the polymyxin group of antibiotics. It acts by binding to the bacterial cell membrane, causing the membrane to become more permeable and resulting in leakage of essential cell contents, leading to bacterial cell death. colistin has a broad spectrum of activity against Gram-ve bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae. It is usually used to treat multidrug-resistant Gram-negative infections. colistin is not effective against Gram-positive bacteria, fungi, or viruses.  

Pharmacodynamics: 

colistin is a bactericidal antibiotic that destroys the bacterial cell membrane and causes cell death. It has narrow spectrum of activity and is active against a limited number of Gram-negative bacteria, including Pseudomonas aeruginosa and Acinetobacter baumannii. colistin works by binding to the bacterial cell membrane, causing disruption of the membrane and subsequent leakage of intracellular components, leading to bacterial cell death. 

colistin is considered a last-resort antibiotic due to its potential for toxicity and the development of resistant strains of bacteria.  

Pharmacokinetics: 

Absorption 

colistin is not absorbed orally and is not effective when given orally. It is administered either intravenously or by inhalation. 

Distribution 

colistin has poor penetration into most tissues and is primarily distributed in extracellular fluid. It does not penetrate the blood-brain barrier. 

Metabolism 

colistin is not metabolized in the body. 

Elimination and excretion 

colistin is excreted unchanged by the kidneys, and its elimination half-life is about 2-3 hours in patients with normal renal function. 

Adminstartion

Administration: 

colistin is administered through intravenous (IV) injection or inhalation. 

For intravenous injection, colistin is usually given slowly over a period of 30-60 minutes. It should not be given as a IV bolus injection. 

For inhalation, colistin is administered using a nebulizer creates a very fine mist that can be inhaled into the lungs. 

The dosage and duration of colistin treatment based on the severity of the patient’s age and weight, the infection, and other factors. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: colistin 

Pronounced: (kuh-LISS-tin)  

Why do we use colistin? 

colistin is an antibiotic that is primarily used to treat infections caused by gram-ve bacteria, such as Pseudomonas aeruginosa and Acinetobacter baumannii. These bacteria are often resistant to other antibiotics, making colistin an important treatment option. colistin is typically reserved for use in the treatment of infections that have not responded to other antibiotics or for infections caused by highly resistant bacteria. It may be used to treat infections of the lungs, bloodstream, urinary tract, and other parts of the body.