title: Evaluation of risk of nephrotoxicity with high dose, extended-interval colistin administration.
abstract: OBJECTIVE
  The aim was to evaluate the risk of nephrotoxicity with high-dose, extended-interval regimen of colistin administration in critical ill patients.
  
  
  METHODS
  This prospective study was conducted on patients suffering from sepsis due to Gram-negative infection susceptible only to colistin. The dosing schedule for colistin was 9 million units stat followed by 4.5 million units at 12 hourly interval (adjusted as per body weight and renal functions). The serum creatinine and creatinine clearance were estimated at the start of therapy and daily during therapy.
  
  
  RESULTS
  Thirty-one patients suffering ventilator associated pneumonia (61.29%), blood stream infections (29.03%) and urinary tract infections (9.67%) due to Gram-negative multiple drug resistance organisms were assessed. Most commonly isolated organism were Acinetobacter baumannii (54.83%), Klebsiella pneumonia (16.12%) and Pseudomonas (29.03%). Five patients (16.12%) developed acute kidney injury within 4-5 days of start of therapy and returned to baseline after 6 days with no patient requiring renal replacement therapy or discontinuation of colistin.
  
  
  CONCLUSIONS
  Our study showed that high-dose, extended-interval colistin can be given to critically ill patients without any significant risk of nephrotoxicity.
authors.affiliation: Department of Medicine and Critical Care, Batra Hospital, New Delhi, India.
authors.forename: Arun
authors.initials: A
authors.lastname: Dewan
authors.affiliation: Department of Medicine and Critical Care, Batra Hospital, New Delhi, India.
authors.forename: Mujeeb
authors.initials: M
authors.lastname: Shoukat
keywords: Extended interval; High-dose colistin; nephrotoxicity
references.citation: Antimicrob Agents Chemother. 2011 Jul;55(7):3284-94
references.pmid: 21555763
references.citation: Chest. 2010 Dec;138(6):1333-9
references.pmid: 20558557
references.citation: Antimicrob Agents Chemother. 2009 Aug;53(8):3430-6
references.pmid: 19433570
references.citation: Lancet Infect Dis. 2006 Sep;6(9):589-601
references.pmid: 16931410
references.citation: Crit Care. 2003 Oct;7(5):R78-83
references.pmid: 12974973
references.citation: Antimicrob Agents Chemother. 2010 Oct;54(10):4503-5
references.pmid: 20660694
references.citation: Clin Ther. 2008 Jan;30(1):143-51
references.pmid: 18343250
references.citation: Int J Antimicrob Agents. 2005 Dec;26(6):504-7
references.pmid: 16280245
references.citation: J Antimicrob Chemother. 2009 Sep;64 Suppl 1:i3-10
references.pmid: 19675017
references.citation: Nephron Clin Pract. 2008;109(4):c182-7
references.pmid: 18802365
references.citation: J Infect Chemother. 2002 Jun;8(2):125-33
references.pmid: 12111564
references.citation: Curr Opin Pulm Med. 2001 Nov;7(6):434-40
references.pmid: 11706322
references.citation: Expert Opin Drug Metab Toxicol. 2011 Feb;7(2):245-55
references.pmid: 21128824
references.citation: Clin Infect Dis. 2005 May 1;40(9):1333-41
references.pmid: 15825037
references.citation: Curr Opin Pharmacol. 2011 Oct;11(5):464-9
references.pmid: 21835694
references.citation: Antimicrob Agents Chemother. 2012 Aug;56(8):4241-9
references.pmid: 22615285
references.citation: Antimicrob Agents Chemother. 2005 Aug;49(8):3136-46
references.pmid: 16048915
references.citation: J Membr Biol. 1996 Nov;154(2):119-30
references.pmid: 8929286
references.citation: J Chemother. 2010 Jun;22(3):175-8
references.pmid: 20566422
references.citation: Int J Antimicrob Agents. 2010 Mar;35(3):297-300
references.pmid: 20045293
references.citation: Ann Intensive Care. 2011 Aug 02;1(1):30
references.pmid: 21906382