Re-emergence of colistin in today's world of multidrug-resistant organisms: personal perspectives.
BACKGROUND
Infections due to multidrug-resistant Gram-negative bacteria (including Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae) are being reported with increasing frequency from various parts of the world.


OBJECTIVE
To share personal perspectives on the clinical use of colistin based on the available evidence reported in the literature as well as on knowledge obtained through our clinical experience with the use of colistin in a considerable number of patients during the past 7 years.


METHODS
Literature review and personal experience.


CONCLUSIONS
During the last decade, clinicians in several countries have resorted to colistin (polymyxin E), an antibiotic that has been shown to be clinically effective and acceptably safe for intravenous, aerosolized, and intrathecal/intraventricular administration. However, more data are needed to answer important clinical questions, including the appropriate colistin dosage, comparison of colistin monotherapy with combination therapy, and the possible preventive and therapeutic role of aerosolized colistin.
Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 15123 Marousi, Athens, Greece. m.falagas@aibs.gr
Matthew E
ME
Falagas
Petros I
PI
Rafailidis
D000818:Animals; D002626:Chemistry, Pharmaceutical; D003091:Colistin / Q000494:pharmacology*; D018432:Drug Resistance, Multiple / Q000187:drug effects*; D004361:Drug Tolerance; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D011113:Polymyxins / Q000494:pharmacology
D011113:Polymyxins; D003091:Colistin