Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jul;18(7):427-30.
doi: 10.4103/0972-5229.136070.

Evaluation of risk of nephrotoxicity with high dose, extended-interval colistin administration

Arun Dewan  1 , Mujeeb Shoukat  1
Affiliations

Evaluation of risk of nephrotoxicity with high dose, extended-interval colistin administration

Arun Dewan et al. Indian J Crit Care Med. 2014 Jul.

Abstract

Aim: The aim was to evaluate the risk of nephrotoxicity with high-dose, extended-interval regimen of colistin administration in critical ill patients.

Materials and methods: This prospective study was conducted on patients suffering from sepsis due to Gram-negative infection susceptible only to colistin. The dosing schedule for colistin was 9 million units stat followed by 4.5 million units at 12 hourly interval (adjusted as per body weight and renal functions). The serum creatinine and creatinine clearance were estimated at the start of therapy and daily during therapy.

Results: Thirty-one patients suffering ventilator associated pneumonia (61.29%), blood stream infections (29.03%) and urinary tract infections (9.67%) due to Gram-negative multiple drug resistance organisms were assessed. Most commonly isolated organism were Acinetobacter baumannii (54.83%), Klebsiella pneumonia (16.12%) and Pseudomonas (29.03%). Five patients (16.12%) developed acute kidney injury within 4-5 days of start of therapy and returned to baseline after 6 days with no patient requiring renal replacement therapy or discontinuation of colistin.

Conclusion: Our study showed that high-dose, extended-interval colistin can be given to critically ill patients without any significant risk of nephrotoxicity.

Keywords: Extended interval; High-dose colistin; nephrotoxicity.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Deryke CA, Crawford AJ, Uddin N, Wallace MR. Colistin dosing and nephrotoxicity in a large community teaching hospital. Antimicrob Agents Chemother. 2010;54:4503–5. - PMC - PubMed
    1. Michalopoulos AS, Falagas ME. Colistin: Recent data on pharmacodynamics properties and clinical efficacy in critically ill patients. Ann Intensive Care. 2011;1:30. - PMC - PubMed
    1. Kumazawa J, Yagisawa M. The history of antibiotics: The Japanese story. J Infect Chemother. 2002;8:125–33. - PubMed
    1. Falagas ME, Kasiakou SK. Colistin: The revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis. 2005;40:1333–41. - PubMed
    1. 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. - PubMed

LinkOut - more resources