title: Colistin: an update on the antibiotic of the 21st century.
abstract: The emergence of multidrug-resistant Gram-negative bacteria that cause nosocomial infections is a growing problem worldwide. Colistin was first introduced in 1952 and was used until the early 1980s for the treatment of infections caused by Gram-negative bacilli. In vitro, colistin has demonstrated excellent activity against various Gram-negative rod-shaped bacteria, including multidrug-resistant Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae. Recent clinical findings regarding colistin activity, pharmacokinetic properties, clinical uses, emerging resistance, toxicities and combination therapy have been reviewed. Recent approaches to the use of colistin in combination with other antibiotics hold promise for increased antibacterial efficacy. It is probable that colistin will be the 'last-line' therapeutic drug against multidrug-resistant Gram-negative pathogens in the 21st century.
authors.affiliation: CNRS-IRD, UMR 6236, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, 27, Boulevard Jean-Moulin, 13385 Marseille Cedex 05, France.
authors.forename: Silpak
authors.initials: S
authors.lastname: Biswas
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Brunel
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Dubus
authors.forename: Martine
authors.initials: M
authors.lastname: Reynaud-Gaubert
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy; D040981:Acinetobacter baumannii / Q000472:pathogenicity; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D002462:Cell Membrane / Q000187:drug effects; D003091:Colistin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy*; D007711:Klebsiella pneumoniae / Q000472:pathogenicity; D011112:Polymyxin B / Q000008:administration & dosage / Q000494:pharmacology; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000472:pathogenicity; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D011112:Polymyxin B; D003091:Colistin