title: [Shedding light on the use of colistin: still gaps to be filled].
abstract: Colistin (polymyxin E), an old antibiotic replaced by other less toxic antibiotics in the 1970s, has been increasingly used over the last decade due to multidrug-resistance in Gram-negative bacteria and lack of new antibiotics. However, there is a dearth of information on the pharmacokinetics (PK), pharmacodynamics (PD) and toxicodynamics (TD) of colistin and its non-active prodrug colistimethate sodium (CMS). Optimised dose regimens have not been established for different types of patients. Additionally, most PK data available in the literature were obtained from concentrations derived from potentially misleading microbiological assays. Therefore, it is urgent to conduct prospective studies to optimise CMS/colistin use in patients, in particular the critically ill. This review summarises recent key clinical studies evaluating the efficacy, toxicity and PK/PD of colistin/CMS.
authors: Servicio de Farmacia, Hospital del Mar, Barcelona, España.
authors: Sonia
authors: S
authors: Luque
authors: Santiago
authors: S
authors: Grau
authors: Nuria
authors: N
authors: Berenguer
authors: Juan Pablo
authors: JP
authors: Horcajada
authors: Luisa
authors: L
authors: Sorlí
authors: María Milagro
authors: MM
authors: Montero
authors: Esther
authors: E
authors: Salas
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003091:Colistin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016638:Critical Illness; D004305:Dose-Response Relationship, Drug; D004333:Drug Administration Routes; D004353:Drug Evaluation, Preclinical; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; C004691:colistinmethanesulfonic acid; D003091:Colistin