title: Strategies for the safe use of colistin.
abstract: Colistin has re-emerged as an essential antibiotic for the treatment of carbapenem-resistant Gram-negative infections. Unfortunately, its utility is limited by high rates of nephrotoxicity, even at potentially therapeutic concentrations, and an overall lack of understanding on how to optimally administer the agent. In this review, recent advancements in the understanding of the safety and efficacy of colistin are discussed and strategies and suggestions on how to balance the two are described.
authors.affiliation: a 1 Department of Pharmacy Services, Parkland Health and Hospital System, Dallas, TX, USA.|b 2 University of Texas Southwestern Medical School, Dallas, TX, USA.
authors.forename: Jessica K
authors.initials: JK
authors.lastname: Ortwine
authors.affiliation: c 3 Department of Pharmacy, Baptist Health Louisville, Louisville, KY, USA.|d 4 University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Sutton
authors.affiliation: e 5 Department of Medicine, Detroit Medical Center, Detroit, MI, USA.|f 6 Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
authors.affiliation: f 6 Wayne State University School of Medicine, Detroit, MI, USA.|g 7 Department of Pharmacy Services, Sinai-Grace Hospital; Detroit Medical Center, Detroit, MI, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Pogue
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015780:Carbapenems / Q000494:pharmacology; D003091:Colistin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004351:Drug Resistance; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D003091:Colistin
keywords: carbapenem-resistance; colistimethate; colistin; nephrotoxicity; pharmacokinetics; polymyxin