Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections.

@article{Falagas2005ColistinTR,
  title={Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections.},
  author={Matthew E. Falagas and Sofia K. Kasiakou},
  journal={Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
  year={2005},
  volume={40 9},
  pages={
          1333-41
        }
}
  • M. Falagas, S. Kasiakou
  • Published 1 May 2005
  • Biology, Medicine
  • Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
The emergence of multidrug-resistant gram-negative bacteria and the lack of new antibiotics to combat them have led to the revival of polymyxins, an old class of cationic, cyclic polypeptide antibiotics. Polymyxin B and polymyxin E (colistin) are the 2 polymyxins used in clinical practice. Most of the reintroduction of polymyxins during the last few years is related to colistin. The polymyxins are active against selected gram-negative bacteria, including Acinetobacter species, Pseudomonas… 

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References

SHOWING 1-10 OF 93 REFERENCES

Aerosolized colistin for the treatment of nosocomial pneumonia due to multidrug-resistant Gram-negative bacteria in patients without cystic fibrosis

TLDR
Although seven of eight patients who received nebulized colistin showed clinical improvement, some patients also received other active antibiotics, and microbiological eradication was demonstrated in only four of the eight patients, the results of this limited study suggest that further studies examining the use of nebulization colist in the treatment of nosocomial pneumonia are merited.

Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients

TLDR
The lack of a control group in the present study does not allow any definite conclusions to be drawn regarding the clinical effectiveness of colistin, but this drug has an acceptable safety profile and its use should be considered in severe infections with multiresistant Gram-negative bacilli.

Intravenous colistin as therapy for nosocomial infections caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii.

  • A. LevinA. Barone S. Costa
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 1999
TLDR
Colistin may be a good therapeutic option for the treatment of severe infections caused by multidrug-resistant P. aeruginosa and A. baumannii.

Toxicity after prolonged (more than four weeks) administration of intravenous colistin

TLDR
Serum creatinine, blood urea, liver function tests, symptoms and signs of neurotoxicity were the main outcomes studied and no serious toxicity was observed in this group of patients who received prolonged intravenous colistin.

Synergistic Activity of Colistin and Ceftazidime against Multiantibiotic-Resistant Pseudomonas aeruginosa in an In Vitro Pharmacodynamic Model

TLDR
Colistin is an older but novel antibiotic that fell into disfavor with clinicians some time ago yet still retains a very favorable antibacterial spectrum, especially for Pseudomonas and Acinetobacter spp.

Pitfalls of polymyxin antimicrobial susceptibility testing of Pseudomonas aeruginosa isolated from cystic fibrosis patients.

TLDR
It was found that the microdilution method is a valid, rapid and cost effective alternative for the determination of polymyxin activity and resistance among common CF pathogens is not rare, thus underlining the necessity of accurate susceptibility testing.

Microbiological Activity and Clinical Efficacy of a Colistin and Rifampin Combination in Multidrug-Resistant Pseudomonas aeruginosa Infections

TLDR
The microbiological and clinical observations suggest that the addition of rifampin to colistin may result in a synergistic bactericidal combination that may be useful in patients with infections caused by MDR P. aeruginosa which are difficult to cure.

Colistin treatment in patients with ICU-acquired infections caused by multiresistant Gram-negative bacteria: the renaissance of an old antibiotic.

TLDR
Colistin should be considered as a treatment option in critically ill patients with infection caused by multiresistant Gram-negative bacilli, especially in patients with a history of renal failure.

A reassessment of the in-vitro activity of colistin sulphomethate sodium.

TLDR
The results show that colistin remains a useful antimicrobial agent against Gram-negative bacteria, particularly those strains which are resistant to more commonly used antibiotics.

Toxicity of Colistin in Cystic Fibrosis Patients

TLDR
It appears that intravenous colistin can be considered for cystic fibrosis patients with strains of P. aeruginosa that are resistant to more commonly used antibiotics.
...