Colistin

제한된
1
C. difficile 위험도
Low
경구생체이용률
N/A

Dosing

2.5-5 mg/kg IV #2-4 (max maintenance dose 475 mg/d)

Note: ALL DOSING IS FOR COLISTIN BASE

2.5-5 mg/kg IV #2-4

Note: ALL DOSING IS FOR COLISTIN BASE

No dose adjustment

CrCl ≥80CrCl 50-79CrCl 30-49CrCl <10Non-HD daysHD daysCRRTNo dose adjustment2.5-3.8 mg/kg IV #22.5 mg/kg IV #1-21.5 mg/kg IV q36h65 mg IV q12h (130 mg/d)Daily dose + 40-50 mg after a 3-4h session (give this supplement with the next regular dose after the dialysis has ended)220 mg q12h (442 mg/d divided q12h)

65 mg + (13 mg per hour of CRRT) q12h = 221 mg q12h

General Information

Infections caused by multidrug-resistant gram-negative organisms including carbapenemase-producing organisms.

Consultation with Infectious Disease is strongly recommended.

Serum creatinine, urine output

  • Nephrotoxicity

  • Neurotoxicity

  • Muscle weakness

  • Dizziness

  • Paresthesias

  • Slurred speech

  • Vertigo

  • Concomitant use of nephrotoxic agents

  • Can enhance the neuromuscular-blocking effect of neuromuscular-blocking agents

Antimicrobial class: Polymyxin

Pregnancy category: C

Pregnancy:

  • No data in human pregnancy.

  • Limited data in animal models do not suggest teratogenicity.

Breastfeeding:

  • Limited data indicate that colistin is minimally excreted into breastmilk following intramuscular administration of colistimethate.

  • Because colistin is poorly absorbed orally, it is unlikely to be absorbed in appreciable amounts by the infant or adversely affect the breastfed infant.

  • However, no studies have evaluated serum levels or adverse effects in breastfed infants whose mothers were receiving colistimethate.

  • Breastfeeding is acceptable with the use of inhaled colistin or colistimethate.

Avoid in myasthenia gravis.

ALL DOSES FOR COLISTIN MUST BE EXPRESSED IN COLISTIN BASE. Colistin Base Activity (CBA) 1 mg is defined to be equivalent to colistimethate sodium (CMS) 30,000 units which is equivalent to ~2.4 mg CMS.

Attribution: Antimicrobial information adapted from BC Women's Hospital

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