Colistin
| Autor: | Natalia V. Ortiz-Zacarias, Ingrid M C Kamerling, Erik B Wilms, Henri A. Verbrugh, Cees van Nieuwkoop, Anneke C. Dijkmans, Daan J Touw, W. Birkhoff |
|---|---|
| Přispěvatelé: | Medical Microbiology & Infectious Diseases |
| Rok vydání: | 2015 |
| Předmět: |
INTENSIVE-CARE-UNIT
Gram-negative bacteria medicine.drug_class Polymyxin Antibiotics Polymyxin Antibiotic Microbial Sensitivity Tests Drug resistance Biology Pharmacology medicine.disease_cause Microbiology Minimum inhibitory concentration Drug Resistance Multiple Bacterial COLISTIMETHATE SODIUM Gram-Negative Bacteria INTRAVENOUS COLISTIN medicine Humans Pharmacology (medical) Colistin Pseudomonas aeruginosa PSEUDOMONAS-AERUGINOSA Drug Synergism POPULATION PHARMACOKINETICS biology.organism_classification Anti-Bacterial Agents RESISTANT ACINETOBACTER-BAUMANNII lipids (amino acids peptides and proteins) CONTINUOUS VENOVENOUS HEMODIAFILTRATION LIQUID-CHROMATOGRAPHY Drug Monitoring CRITICALLY-ILL PATIENTS medicine.drug |
| Zdroj: | Therapeutic Drug Monitoring, 37(4), 419-427 Therapeutic Drug Monitoring, 37(4), 419-427. Lippincott Williams & Wilkins |
| ISSN: | 0163-4356 |
| DOI: | 10.1097/ftd.0000000000000172 |
| Popis: | Colistin (polymyxin E) is a positively charged deca-peptide antibiotic that disrupts the integrity of the outer membrane of the cell wall of gram-negative bacteria by binding to the lipid A moiety of lipopolysaccharides, resulting in cell death. The endotoxic activity of lipopolysaccharides is simultaneously inhibited. Colistin is increasingly being prescribed as rescue treatment for infections with multidrug-resistant bacilli. Nephrotoxicity and, to a lesser degree, neurotoxicity occur often during systemic colistin therapy, and have severely limited its application in the past. However, these side effects are largely reversible and can be managed through close monitoring. The prodrug colistimethate sodium (CMS) is less toxic and is, therefore, the preferred formulation for parenteral administration. Importantly, resistance to colistin seems to emerge often unless it is combined with another antibiotic, but further studies into this phenomenon are necessary. Pharmacokinetic and pharmacodynamic properties have received little attention, partly because of the physicochemical peculiarities of polymyxin antibiotics, especially their propensity to stick to other molecules and surfaces. The ratio between the area under the curve of free colistin and the pathogen's Minimal Inhibitory Concentration (MIC) best predicts microbiological and clinical responses, but more studies are needed in this area. Likewise, further standardization is needed in production and labeling of colistin formulations, and in the way the susceptibility of bacteria to colistin is determined. |
| Databáze: | OpenAIRE |
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