Antimicrobials
Colistin

Colistin

Restricted

Low
N/A
$$$/day (70kg patient)

Spectrum of Activity

General Information

Multi-Drug Resistant (MDR) Pseudomonas, Acinetobacter, and Enterobacterales infections. 

Polymyxin B is preferred over colistin for all MDR-GNB systemic infections outside of the urinary tract due to more predictable pharmacokinetics.

Colistin is preferred for urinary tract infections.

For treatment of MDR-GNB respiratory tract infections, administered as nebulization as 150mg inhaled q12hr.

Laboratory:

  • BMP
  • Urine output

Clinical:

  • Mental status changes/seizures
  • Nephrotoxicity
  • Neurotoxicity

Antimicrobial class: Polymyxin

Pregnancy category: C

Average serum half life: 2-3 hours for Colistimethate sodium (CMS): prodrug and >4 hours for colistin (extended with renal impairment)

Lung penetration: Poor

Urine penetration: Therapeutic

CSF penetration: Poor