Adult: As colistin sulfate: 1.5-3 MIU tid. Child: As colistin sulfate: <15 kg: Not suitable; 15-30 kg: 0.75-1.5 MIU tid.
Parenteral Severe Gram-negative infections
Adult: As colistimethate Na (strength expressed in terms of colistin base): 2.5-5 mg/kg/day in 2-4 divided doses. Max: 5 mg/kg/day. Child: As colistimethate Na (strength expressed in terms of colistin base): 2.5 mg/kg/day divided 6-12 hrly.
1.5 mg/kg 36hrly.
2.5 mg/kg/day once daily or in 2 divided doses.
2.5-3.8 mg/kg/day in 2 divided doses.
Same as adult dose.
Reconstitute 150 mg vial w/ 2 mL sterile water for inj. Reconstituted soln provides colistimethate Na at a concentration equivalent to 75 mg/mL colistin base.
Hypersensitivity. Myasthenia gravis.
Patients w/ renal impairment, porphyria. Pregnancy and lactation.
Superinfection; renal damage; visual disturbances; GI disturbances, dizziness, nausea, vomiting; confusion, peripheral neuropathy; respiratory insufficiency and muscle weakness. Potentially Fatal: Severe colitis.
Patient Counseling Information
Due to neurologic disturbances that may occur, if affected, do not drive or operate machinery.
Monitor serum creatinine and BUN regularly while on treatment.
Symptoms: Signs of neuromuscular blockade e.g. paraesthesia, lethargy, confusion, ataxia, dizziness, apnoea. Possible respiratory arrest and acute renal failure. Management: Supportive treatment and steps to increase elimination rate of colistin e.g. mannitol diuresis, prolonged haemodialysis or peritoneal dialysis.
Description: Colistin is a polymyxin antibiotic which is active against aerobic gram-ve bacteria including most enterobacteria except Proteus, Providentia and Serratia. Susceptible organisms include P. aeruginosa, Legionella spp, H. influenzae, Acinetobacter, V. cholera, Salmonella, Shigella and Pasteurella. It acts as a cationic detergent that causes leaking of intracellular substances and cell death by damaging the bacterial cytoplasmic membrane. Pharmacokinetics: Absorption: Poorly absorbed from the GI tract. Time to peak plasma concentration: 2-3 hr (IM). Distribution: Reversibly bound to body tissues; diffuses across the placenta but negligible into the CSF except in infants. Enters breast milk. Excretion: More rapid in childn than in adults; diminished in patients with renal impairment.
Store between 20-25°C. Reconstituted soln: Store between 2-8°C.
Anon. Colistin (Colistimethate) . Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 11/08/2015.Buckingham R (ed). Colistin Sulfate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/08/2015.Colistimethate for Injection (JHP Pharmaceuticals, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 11/08/2015.McEvoy GK, Snow EK, Miller J et al (eds). Colistimethate Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 11/08/2015.