The clinical use of colistin in patients with cystic fibrosis

  title={The clinical use of colistin in patients with cystic fibrosis},
  author={Paul M. Beringer},
  journal={Current Opinion in Pulmonary Medicine},
  • P. Beringer
  • Published 1 November 2001
  • Medicine, Biology
  • Current Opinion in Pulmonary Medicine
Colistin is a cationic polypeptide antibiotic from the polymyxin family that was first introduced in 1962 but abandoned in the early 1970s because of initial reports of severe toxicities. However, a recent increase in the prevalence of multidrug resistant (MDR) Pseudomonas aeruginosa and the lack of novel agents in development calls for a need to re-examine the role of colistin therapy in patients with cystic fibrosis. Current data supports the use of intravenous colistimethate for the… 

Parenteral and inhaled colistin for treatment of ventilator-associated pneumonia.

  • P. LindenD. Paterson
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2006
Colistin is a reasonably safe last-line therapeutic alternative for pneumonia due to multi- or panresistant P. aeruginosa or A. baumannii treated with intravenous colistin, and aerosolized therapy as an adjunct to systemic treatment appears promising.

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

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.

Comparative efficacy of two doses of nebulized colistimethate in the eradication of Pseudomonas aeruginosa in children with cystic fibrosis.

There is no difference in the efficacy between a 30 mg dose and a 75 mg dose of colistimethate for P aeruginosa eradication in children with CF and intermittent colonization.


Background: A long-term plating of Pseudomonas aeruginosa in patients with cystic fibrosis is a sign of damage of the lung tissues with rapid progression of the disease and decrease in a respiratory

Pharmacokinetics and Pharmacodynamics of Aerosolized Antibacterial Agents in Chronically Infected Cystic Fibrosis Patients

  • A. Dalhoff
  • Medicine, Biology
    Clinical Microbiology Reviews
  • 2014
It is nonetheless obvious that systemic exposure of patients with cystic fibrosis is minimized and that the burden of oral treatment for CF patients suffering from chronic infections is reduced.

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

Aerosolized colistin may be a beneficial adjunctive treatment in the management of nosocomial pneumonia (ventilator associated or not) due to multidrug-resistant Gram-negative bacteria.

Antibiotic Therapy against Pseudomonas aeruginosa in Cystic Fibrosis

To treat acute exacerbation, the authors suggest using intravenous administration of two different classes of antibiotics, which can provide a high concentration at the desired site with minimal absorption and therefore low risk of toxicity.

Antimicrobial Susceptibility and Synergy Studies of Stenotrophomonas maltophilia Isolates from Patients with Cystic Fibrosis

To determine appropriate treatment for patients with CF, it is important to monitor the prevalence, antimicrobial susceptibility, and clinical impact of S. maltophilia in this patient population.



Toxicity of Colistin in Cystic Fibrosis Patients

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.

Intravenous colistin sulphomethate in acute respiratory exacerbations in adult patients with cystic fibrosis.

Assessment of the individual effect of each treatment regimen suggests a greater efficacy when colistin is combined with a second antibiotic to which the pseudomonas shows in vitro sensitivity, and changes in renal function should be monitored.

Use of aerosolized colistin sodium in cystic fibrosis patients awaiting lung transplantation.

Aerosolized colistin sodium may be a useful therapy to promote emergence of sensitive microbes in CF candidates with pan-resistant isolates of Pseudomonas.

Early treatment of Pseudomonas aeruginosa colonization in cystic fibrosis

A preliminary trial to assess if early combined systemic and aerosol therapy can delay the onset of chronic infection with Pseudomonas aeruginosa and if this approach can halt the progression to chronic infection has gained widespread acceptance.

The Pharmacokinetics of Colistin in Patients with Cystic Fibrosis

The safety and pharmacokinetics of colistin were determined after first dose and again under steady‐state conditions in 31 patients with cystic fibrosis receiving the drug as a component of their treatment for an acute pulmonary exacerbation of their disease and suggest slow upward dose titration to minimize the incidence and severity of associated side effects.

Comparison of a beta-lactam alone versus beta-lactam and an aminoglycoside for pulmonary exacerbation in cystic fibrosis.

It is concluded that the combination of a beta-lactam and an aminoglycoside produces a longer clinical remission than a Beta- lactam alone and slightly better initial improvement.

Four years' experience of intravenous colomycin in an adult cystic fibrosis unit.

In the authors' experience intravenous colomycin sulphomethate in moderate doses is an effective and safe antipseudomonal antibiotic which is easy to administer and other clinicians should consider its use in patients with cystic fibrosis.

Safety and Tolerability of Bolus Intravenous Colistin in Acute Respiratory Exacerbations in Adults with Cystic Fibrosis

This study indicates that the administration of bolus intravenous colistin as 2 mega-units (160 mg) in 10 mL of NaCl 0.9% three × a day is safe and well-tolerated by patients with total indwelling venous access systems.

Antibiotic treatment of initial colonization with Pseudomonas aeruginosa postpones chronic infection and prevents deterioration of pulmonary function in cystic fibrosis

Although some of the treated patients eventually developed chronic PA infection, these patients had significantly better pulmonary function at the onset of chronicPA infection compared with control patients, and there was a trend suggesting that 3 months of high‐dose treatment with colistin inhalation and oral ciprofloxacin produced the best results in terms of postponement or prevention.