Classes
DEA Class; Rx
Common Brand Names; colistimethate sodium, Coly Mycin M
- Antibiotics, Other
Description
Structurally similar to polymyxin B; colistimethate hydrolyzed to colistin in vitro or in vivo
Cationic detergent that damages bacterial cytoplasmic membrane, causing cell death
Indications
Indicated for treatment of Susceptible Infections
Gram-neg. infection (e.g., Enterobacter aerogenes, E. coli, Klebsiella, Pseudomonas) unresponsive to other antibiotics
Multi-drug resistant gram-neg. infection
Contraindications
Hypersensitivity
Adverse Effects
- Dizziness
- Paresthesia
- Tingling of extremities and tongue
- Neurotoxicity
- Nephrotoxicity
- Acute respiratory failure (inhalation route)
- Respiratory tract paralysis
- Slurred speech
- Vertigo
- Seizures
- Anaphylaxis
Warnings
Do not exceed 5 mg/kg/day (as colistin base) with normal renal function (see Dosing for renal impairment)
Not indicated for infections by Proteus or Neisseria (most strains are resistant)
Risk of nephrotoxicity, neurotoxicity; discontinue if elevated BUN/creatinine
Risk of respiratory arrest in myasthenia gravis or concomitant anesthetics or neuromuscular blocking drugs
Risk of C. difficile-associated pseudomembranous colitis
Sedative effects may impair driving, operating machinery
Colistimethate sodium preferred for treatment of lower urinary tract infections because of higher urinary concentrations, including polymyxin B; use in combination with other antibiotics depending on susceptibilities
Pregnancy and Lactation
Pregnancy Category: C
Lactation: unknown; use caution
Maximum Dosage
2.5-5 mg/kg/day divided q6-12hr IV/IM; not to exceed 5 mg/kg/day
Pediatric
Dosage expressed in terms of colistin bas
<12 years old: Safety and efficacy not established
How supplied
Colistin
powder for injection
- 150mg/vial