Pharmacological agents for the prevention of colistin-induced nephrotoxicity

Abstract

Background Colistin is a polymyxin antibiotic which has been used for treatment of Gram-negative infections, but it was withdrawn due to its nephrotoxicity. However, colistin has gained its popularity in recent years due to the reemergence of multidrug resistant Gram-negative infections and drug-induced toxicity is considered as the main obstacle for using this valuable antibiotic. Results In total, 30 articles, including 29 animal studies and one clinical trial were included in this study. These compounds, including aged black garlic extract, albumin fragments, alpha lipoic acid, astaxanthin, baicalein, chrysin, cilastatin, colchicine, curcumin, cytochrome c, dexmedetomidine, gelofusine, grape seed proanthocyanidin extract, hesperidin, luteolin, lycopene, melatonin, methionine, N-acetylcysteine, silymarin, taurine, vitamin C, and vitamin E exhibited beneficial effects in most of the published works. Conclusions In this review, the authors have attempted to review the available literature on the use of several compounds for prevention or attenuation of colistin-induced nephrotoxicity. Most of the studied compounds were potent antioxidants, and it seems that using antioxidants concomitantly can have a protective effect during the colistin exposure.

Omeprazole Prevents Colistin-Induced Nephrotoxicity in Rats: Emphasis on Oxidative Stress, Inflammation, Apoptosis and Colistin Accumulation in Kidneys

“…In this study, the biochemical and histopathological studies indicated that colistin nephrotoxicity was associated with a reduced glomerular filtration rate and collagen deposition. This is in line with the reported marker of colistin nephrotoxicity [ 21 , 22 ]. Interestingly, omeprazole alleviated such markers, thereby confirming its protective activity.…”

A Synopsis of Current Theories on Drug-Induced Nephrotoxicity

“…If it is necessary to use drugs with significant potential nephrotoxicity, detailed recommendations are developed to prevent their harmful effects on the kidneys. For example, reference can be made to the prophylactic use of antioxidant compounds (vitamin E, vitamin C, flavonoids, melatonin, N-acetylcysteine, luteolin, lycopene, or coenzyme Q10) that reduce free radical damage in the course of the use of drugs that increase oxidative stress in kidney tissues, e.g., during treatment with vancomycin [ 101 ], cyclophosphamide [ 102 ], colistin [ 103 ], cyclosporine A [ 104 ], tacrolimus [ 105 ], contrast media [ 106 ], and cisplatin [ 107 ]. Antioxidants, vitamins, and minerals were also demonstrated to prevent gentamicin-induced nephrotoxicity [ 108 ].…”

Prevention and management of antibiotic associated acute kidney injury in critically ill patients: new insights

“…Unfortunately, very few clinical trials have been performed to guide this therapy, and most studies used animal models or in silico models. A recent review by Mirjaili et al [40] highlighted methods performed to reduce colistin nephrotoxicity.…”