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What is Colistin?

For the past fifty years, the inactive prodrug colistin methanesulfonate has been sold alongside colistin (also known as polymyxin E). The medication was one of the first antibiotics to show against Gram-negative bacteria, especially Pseudomonas aeruginosa. It has a rapid bactericidal activity that is concentration-dependent. Bacillus colistin produces a cyclic polypeptide antibiotic. Polymyxins E1 and E2 (also known as Colistins A, B, and C) are detergents that function on cell membranes. Colistin is less toxic than Polymyxin B, but otherwise, they are very similar.

Colistin Uses

Colistin is an antibiotic that is used for the treatment of various bacterial infections. The drug is used to treat a certain type of serious infection that is not responding to other antibiotics. It kills bacteria by destroying the bacterial cell membrane. The drug is also useful for treating infections of the stomach and the intestine caused due to sensitive gram-negative bacteria and is used for the prevention of bowel sterilization before any surgery is performed.

Colistin Side Effects

Some of the common side effects of Colistin are:

Some of the serious side effects of Colistin are:

  • Burning or tingling sensation
  • Stomach discomfort and cramps
  • Weakness of arms, hands, legs and feet
  • Severe difficulty while breathing
  • Blood in urine
  • Skin irritation

While a person is under the treatment of this drug they might experience certain side effects that may not be adverse. But if your reactions persist or worsen over time then contact your doctor immediately.

Precautions

Before using Colistin talk with your doctor if you are allergic to it or any other medications related to it. The medications may contain some inactive ingredients which will cause serious allergic reactions to your body. Before using the medication talk with your doctor if you have any medical history such as Kidney disease, liver disease and diseases of nerves or muscles. Tell your doctor or dentist that you are taking this drug before getting surgery or other operation that needs anaesthesia or drugs that obstruct nerve or muscle function. Live bacterial vaccines (such as the typhoid vaccine) may be affected by this drug. Avoid getting vaccinated unless your doctor asks you to.

How to use Colistin?

Colistin for injection is given into the vein or muscle as directed by the doctor. Mainly, the dosage depends on the medical condition and response towards the treatment. If you are taking this medication at home learn all the preparation and usage instructions from the doctor.

Dosage Forms and Strengths

Dose: 150 mg (powder for injection)

Susceptible infections: 2.5 mg/kg/day divided in every 6-12 hours intravenously/ intramuscularly

Renal Impairment: 2.5-3.8 mg/kg/day IV/IM divided in every 12 hours

Overdose

You may experience symptoms such as stomach ache, nausea, and vomiting if you accidentally took too much of this medication. If you have taken an overdose of the drug, contact your doctor right away or go to the nearest hospital.

Missed Dose

It is important to take this drug exactly as prescribed in order to get the most benefit. If you miss an injection, call your doctor or pharmacist as soon as possible to set up a new dosing schedule. To catch up, do not double the dose. If you forget to take an inhaled dose, do so as soon as possible. If it’s time for the next dose skip the missed dose and take the next dose.

Storage

Direct contact with heat, air and light may damage your medicines. Exposure to medicine may cause some harmful effects. The medicine must be kept in a safe place and out of children’s reach.

Mainly the drug should be kept at room temperature between 68ºF and 77ºF (20ºC and 25ºC).

Warnings for serious Health Conditions

Neurotoxicity

In certain patients, this medication has been linked to brain injury, memory problems, anxiety, depression, and other psychiatric disorders. Before starting therapy for this drug, tell your doctor if you have ever had a mental disorder.

Pregnancy & Breastfeeding

If the benefits outweigh the risks, use colistin with caution during pregnancy. Animal studies suggest a risk, but human studies are either unavailable or have not been performed.
It's unclear if the drug moves through breast milk or how it could affect a nursing baby. Breastfeeding should be done with caution. Before taking the medication talk to your doctor if you are breastfeeding.

Colistin vs Meropenem

Colistin

Meropenem
Colistin is an antibiotic that is used for the treatment of various bacterial infections. The drug is used to treat a certain type of serious infection that is not responding to other antibiotics. Meropenem injection belongs to the antibiotic class of medications. It kills the bacteria that cause infection.
The drug is also useful for treating infections of the stomach and the intestine caused due to sensitive gram-negative bacteria and is used for the prevention of bowel sterilization before any surgery is performed. Meropenem injection is used for treating bacterial skin and abdominal infections, as well as meningitis.
Some of the common side effects of Colistin are:
  • Kidney damage
  • Diarrhea
  • Nausea
  • Vomiting
 Some common side effects are:
  • Headache
  • Diarrhea
  • Constipation
  • Nausea

Citations

Colistin Dosing and Nephrotoxicity in a Large Community Teaching Hospital, ID:10.1128/aac.01707-09 Updated US and European Dose Recommendations for Intravenous Colistin: How Do They Perform?, ID:10.1093/cid/civ964

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Frequently Asked Questions

What is colistin medication used for?

Colistin is an antibiotic that is used for the treatment of various bacterial infections. The drug is used to treat a certain type of serious infection that is not responding to other antibiotics. It kills bacteria by destroying the bacterial cell membrane.

What are the side effects of colistin?

Some of the common & major side effects of Colistin are:

  • Kidney damage
  • Vomiting
  • Nausea
  • Diarrhea

Why is colistin a last-resort antibiotic?

The gene has the ability to spread rapidly to other bacteria, increasing the risk that bacteria that are already immune to major antibiotics will also become resistant to colistin. Colistin is an important last-ditch choice. Because of its side effects, the medication is seldom used in routine treatment.

How do you give colistin?

Colistin can be given as an aerosol or as an intramuscular or intravenous injection after reconstitution with 0.9 percent sodium chloride injection or sterile water for injection. When necessary, however, colistin may be administered in other ways, such as intrathecally.

When do you use colistin?

Intravenous polymyxin B and colistin have recently become more widely used in the treatment of otherwise pan-resistant nosocomial infections, especially those caused by Pseudomonas and Acinetobacter spp. They're also used in aerosol form for cystic fibrosis patients.

Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.