El desafio en la dosificación de colistin: actualización de las recomendaciones disponibles

Abstract

Polymyxins have been available since the 1960s, however, because of their adverse effects, their use has been reserved for the treatment of infections caused by multiresistant bacteria. The increase in the clinical experience acquired in recent years and the published medical literature have raised doubts about the information provided by the product, indicating the need to update dosage recommendations, pharmacokinetics and pharmacokinetic/pharmacodynamic information (PK/PD). In addition, differences in concentration and dose between the different products of colistin may lead to errors of indication/administration and pose a risk to patients. In 2013, the European Medicines Agency (EMA) commissioned the Committee for Medicinal Products for Human Use (CHPM) to review available data and to make updated recommendations on the use of colistin. This procedure yielded a first report in 2014. This review highlights critical safety and efficacy aspects, reviews the recent pharmacokinetic and stability advances, the available pharmaceutical forms in Chile, providing the schemes currently recommended by health care agencies and experts in the field.

mcr-mediated colistin resistance in South America, a One Health approach: a review

“…However, colistin and polymyxin B's intravenous formulations were gradually abandoned in most parts of the world in the early 1980s because of the high incidence of nephrotoxicity reported. Subsequently, the intravenous use of colistin was mainly restricted during the past two decades for the treatment of lung infections because of multidrug-resistant (MDR) for Gram-negative bacteria in patients with cystic fibrosis [16][17][18][19].…”