Adult: As colistin sulfate: 1.5-3 MIU tid. Child: As colistin sulfate: <15 kg: Not suitable; 15-30 kg: 0.75-1.5 MIU tid.
Parenteral Severe Gram-negative infections
Adult: As colistimethate Na (strength expressed in terms of colistin base): 2.5-5 mg/kg/day in 2-4 divided doses. Max: 5 mg/kg/day. Child: As colistimethate Na (strength expressed in terms of colistin base): 2.5 mg/kg/day divided 6-12 hrly.
1.5 mg/kg 36hrly.
2.5 mg/kg/day once daily or in 2 divided doses.
2.5-3.8 mg/kg/day in 2 divided doses.
Same as adult dose.
Hướng dẫn pha thuốc
Reconstitute 150 mg vial w/ 2 mL sterile water for inj. Reconstituted soln provides colistimethate Na at a concentration equivalent to 75 mg/mL colistin base.
Chống chỉ định
Hypersensitivity. Myasthenia gravis.
Patients w/ renal impairment, porphyria. Pregnancy and lactation.
Phản ứng phụ
Superinfection; renal damage; visual disturbances; GI disturbances, dizziness, nausea, vomiting; confusion, peripheral neuropathy; respiratory insufficiency and muscle weakness. Potentially Fatal: Severe colitis.
Thông tin tư vấn bệnh nhân
Due to neurologic disturbances that may occur, if affected, do not drive or operate machinery.
Monitor serum creatinine and BUN regularly while on treatment.
Symptoms: Signs of neuromuscular blockade e.g. paraesthesia, lethargy, confusion, ataxia, dizziness, apnoea. Possible respiratory arrest and acute renal failure. Management: Supportive treatment and steps to increase elimination rate of colistin e.g. mannitol diuresis, prolonged haemodialysis or peritoneal dialysis.
Description: Colistin is a polymyxin antibiotic which is active against aerobic gram-ve bacteria including most enterobacteria except Proteus, Providentia and Serratia. Susceptible organisms include P. aeruginosa, Legionella spp, H. influenzae, Acinetobacter, V. cholera, Salmonella, Shigella and Pasteurella. It acts as a cationic detergent that causes leaking of intracellular substances and cell death by damaging the bacterial cytoplasmic membrane. Pharmacokinetics: Absorption: Poorly absorbed from the GI tract. Time to peak plasma concentration: 2-3 hr (IM). Distribution: Reversibly bound to body tissues; diffuses across the placenta but negligible into the CSF except in infants. Enters breast milk. Excretion: More rapid in childn than in adults; diminished in patients with renal impairment.
Store between 20-25°C. Reconstituted soln: Store between 2-8°C.
Anon. Colistin (Colistimethate) . Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 11/08/2015.Buckingham R (ed). Colistin Sulfate . Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/08/2015.Colistimethate for Injection (JHP Pharmaceuticals, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 11/08/2015.McEvoy GK, Snow EK, Miller J et al (eds). Colistimethate Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 11/08/2015.