Efficacy and Safety of Colistin in Clinical Practice
Article Sidebar
Main Article Content
Abstract
Colistin (polymyxin E) is an antimicrobial agent in the polymyxins group. Its mechanism of action is like detergent by interfering with the transmission of various substances into cytoplasmic bacteria cells. The drug commonly used for treatment of infection is colistin methanesulfonate (CMS), which is less toxic than colistin sulfate. CMS has been used for treatment of gram-negative bacterial infections especially those caused by multidrug resistant pathogens such as Acinetobacter spp, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumonia. At present, these pathogens remain susceptible to colistin for more than 90%. CMS is a non-active prodrug. However, it becomes active substance, colistin, after being hydrolyzed in vivo. Colistin is mainly distributed in blood stream and is poorly distributed to the lung parenchyma and cerebrospinal fluid. CMS is mainly excreted through kidney, while colistin elimination is essentially extrarenal. CMS can be administered by intramuscular, intravenous, inhalation, and intraventricular/intrathecal route. Colistin causes major adverse reactions, including renal toxicity and neurotoxicity. Appropriate dosing and duration of treatment with colistin should be applied to prevent nephrotoxicity and nephrotoxicity.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
2. Michalopoulos A, Falagas ME. Colistin and polymyxin B in critical care. Crit Care Clin. 2008; 24: 377-91.
3. Zavascki AP, Goldani LZ, Li J, Nation RL. Polymyxin B for the treatment of multidrug-resistant pathogens: a critical review. J Antimicrob Chemother. 2007; 60: 1206-15.
4. Bialvaei AZ, Samadi Kafil H. Colistin, mechanisms and prevalence of resistance. Curr Med Res Opin. 2015; 31: 707-21.
5. Li J, Nation RL, Turnidge JD, Milne RW, Coulthard K, Rayner CR, et al. Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections. Lancet Infect Dis. 2006; 6: 589-601.
6. Biswas S, Brunel JM, Dubus JC, Reynaud-Gaubert M, Rolain JM. Colistin: an update on the antibiotic of the 21st century. Expert Rev Anti Infect Ther. 2012; 10: 917-34.
7. Dijkmans AC, Wilms EB, Kamerling IM, Birkhoff W, Ortiz-Zacarias NV, van Nieuwkoop C, et al. Colistin: Revival of an Old Polymyxin Antibiotic. Ther Drug Monit. 2015; 37: 419-27.
8. Pongpech P, Amornnopparattanakul S, Panapak dee S, Fungwithaya S, Nannha P, Dhiraputra C, et al. Antibacterial activity of carbapenem-based combinations againts multidrug-resistant Acineto bacter baumannii. J Med Assoc Thai. 2010; 93: 161-71.
9 Olaitan AO, Diene SM, Kempf M, Berrazeg M, Bakour S, Gupta SK, et al. Worldwide emergence of colistin resistance in Klebsiella pneumoniae from healthy humans and patients in Lao PDR, Thailand, Israel, Nigeria and France owing to inactivation of the PhoP/PhoQ regulator mgrB: an epidemiological and molecular study. Int J Anti microb Agents. 2014; 44: 500-7.
10. Kiratisin P, Tiengrim, Yungyuen T, Thamlikitkul V. In vitro activity of colistin and tigecycline against extended-spectrum-beta-lactamase (ESBL)-produ cing Escherichia coli and Klebsiella pneumoniae isolated from patients in Siriraj Hospital. J nfect Dis Antimicrob Agents. 2006; 23: 21-4.
11. Tunyapanit W, Pruekprasert P, Laoprasopwattana K, Chelae S. In vitro activity of colistin against multidrug-resistant Pseudomonas aeruginosa isolates from patients in Songklanagarind Hospital, Thailand. Southeast Asian J Trop Med Public Health. 2013; 44: 273-80.
12. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial suscep tibility testing. 28th ed. Wayne: Clinical and Laboratory Standards Institute; 2018.
13. The European Committee on Antimicrobial Suscep tibility Testing. Breakpoint tables for interpretation of MICs and zone diameters Version 8.1 [online]. 2018 [cited July 9, 2018]. Available from: www.eu cast.org/clinical_breakpoints/.
14. Colistimethate Sodium. In: In depth answers [database on the Internet]. Greenwood Village (CO): Truven Health Analytics; 2018 [cited 2018 April 5]. Available from: www.micromedexsolutions .com.
15. Fiaccadori E, Antonucci E, Morabito S, d'Avolio A, Maggiore U, Regolisti G. Colistin use in patients with reduced kidney function. Am J Kidney Dis. 2016; 68: 296-306.
16. Bergen PJ, Li J, Nation RL. Dosing of colistin-back to basic PK/PD. Curr Opin Pharmacol. 2011; 11: 464-9.
17. Food and drug administration. Colistin [online]. 2018 [cited April 9, 2018]. Available from: pertento.fda.moph.go.th/FDA_SEARCH_DRUG/SEARCH_DRUG/FRM_SEARCH_DRUG.aspx
18. Colistate 150. In: MIMS Online [database on the Internet]. MIMS Thailand; 2018 [cited April 5, 22001188]. Available from: www.mims.com/thailand/ drug/info/colistate%20150/?type=brief
19. Garonzik SM, Li J, Thamlikitkul V, Paterson DL, Shoham S, Jacob J, et al. Population pharmaco kinetics of colistin methanesulfonate and formed colistin in critically ill patients from a multicenter study provide dosing suggestions for various categories of patients. Antimicrob Agents Chemo ther 2011; 55: 3284-94.
20. Nation RL, Garonzik SM, Thamlikitkul V, Giamarel los-Bourboulis EJ, Forrest A, Paterson DL, et al. Dosing guidance for intravenous colistin in critically-ill patients. Clin Infect Dis. 2017; 1; 64: 565-71.
21. Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016; 63: e61-e111.
22. Valachis A, Samonis G, Kofteridis DP. The role of aerosolized colistin in the treatment of ventilator-associated pneumonia: a systematic review and metaanalysis. Crit Care Med. 2015; 43: 527-33.
23. Kaatip W, Santimaleeworagun W, Sabprasert T, Pongpa O, Oberdorfer P. Efficacy and Tolerability of nebulized 80-mg colistin in patients with hospital-acquired pneumonia and ventilator asso ciated pneumonia caused by Acinetobactor bau mannii. Thai Pharm Health Sci J. 2016;11:126-31.
24. Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, et al. 2017 Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis. Clin Infect Dis. 2017; doi: 10.109 3/cid/ciw861.
25. Bargiacchi O, Rossati A, Car P, Brustia D, Brondolo R, Rosa F, et al. Intrathecal/intraventri cular colistin in external ventricular device-related infections by multi-drug resistant Gram negative bacteria: case reports and review. Infection. 2014; 42: 801-9.
26. Kelesidis T, Falagas ME. The safety of polymyxin antibiotics. Expert Opin Drug Saf. 2015; 14: 1687-701.
