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VOLUME 13 , ISSUE 2 ( June, 2009 ) > List of Articles

REVIEW ARTICLE

Colistin and polymyxin B: A re-emergence

Ashima Malhotra, Prem N. Kakar, Deep Arora, Shibani Das, Pradeep Govil

Keywords : Multidrug-resistant organisms, polymyxins

Citation Information : Malhotra A, Kakar PN, Arora D, Das S, Govil P. Colistin and polymyxin B: A re-emergence. Indian J Crit Care Med 2009; 13 (2):49-53.

DOI: 10.4103/0972-5229.56048

License: CC BY-ND 3.0

Published Online: 01-06-2009

Copyright Statement:  Copyright © 2009; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

One of the greatest achievements of modern medicine is the development of antibiotics against life-threatening infections, but the emergence of multidrug-resistant (MDR) gram negative bacteria has drastically narrowed down the therapeutic options against them. This limitation has led clinicians to reappraise the clinical application of polymyxins, an old class of cationic, cyclic polypeptide antibiotics. Polymyxins are active against selected gram-negative bacteria, including the Acinetobacter species, Pseudomonas aeruginosa, Klebsiella species, and Enterobacter species. In this article, we summarise the chemistry, pharmacokinetics, and pharmacodynamics of polymyxins and the latest understanding of their action against MDR pathogens.


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  1. Problem pathogens (Pseudomonas aeruginosa and Acinetobacter). Semin Respir Infect 2000;15:287-98.
  2. Surveillance of antibiotics resistance in European ICUs. J Hosp Infect 2001;48:161-76.
  3. Resistance patterns among nosocomial pathogens: Trends over the past few years. Chest 2001;119:397S-404.
  4. Clinical relevance of Acinetobacter baumannii ventilator-associated pneumonia. Crit Care Med 2003;31:2557-9.
  5. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002;165:867-903.
  6. Polymyxin and related peptide antibiotics. Annu Rev Biochem 1977;46:723-63.
  7. Polymyxin B sulfate and colistin: Old antibiotics for emerging multiresistant gram-negative bacteria. Ann Pharmacother 1999;33:960-7.
  8. Partial purification and properties of L-2,4-diaminobutyric acid activating enzyme from a polymyxin E producing organism. J Biochem 1979;86:1013-21.
  9. Isolation and structural characterization of colistin components. J Antibiot (Tokyo) 2001;54:595-9.
  10. Activity of colistin against Pseudomonas aeruginosa: Inhibition by calcium. J Infect Dis 1971;124:610-2.
  11. The properties and mode of action of the polymyxins. Bacteriol Rev 1956;20:14-27.
  12. Interaction of divalent cations and polymyxin B with lipopolysaccharide. Biochemistry 1979;18:4425-30.
  13. Colistin methanesulfonate is an inactive prodrug of colistin against Pseudomonas aeruginosa. Antimicrob Agents Chemother 2006;50:1953-8.
  14. Evaluation of colistin as an agent against multi-resistant Gram-negative bacteria. Int J Antimicrob Agents 2005;25:11-25.
  15. Stability of colistin and colistin methanesulfonate in aqueous media and plasma as determined by high-performance liquid chromatography. Antimicrob Agents Chemother 2003;47:1364-70.
  16. Pharmacokinetics of colistin methanesulphonate and colistin in rats following an intravenous dose of colistin methanesulphonate. J Antimicrob Chemother 2004;53:837-40.
  17. Bexley Kent. UK: Forest Laboratories UK Ltd; 2004.
  18. Sodium sulphomethyl derivatives of polymyxins. Br J Pharmacol Chemother 1964;23:552-74.
  19. A reassessment of the in-vitro activity of colistin sulphomethate sodium. J Antimicrob Chemother 1997;39:255-60.
  20. In vitro pharmacodynamics of colistin against Acinetobacter baumannii clinical isolates. J Antimicrob Chemother 2007;59:473-7.
  21. The in-vitro activity of colistin in gram-negative bacteria. Singapore Med J 2006;47:621-4.
  22. Mosman, NSW, Australia: Link Medical Products Pty Ltd; 2006.
  23. Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients. Crit Care 2003;7:78-83.
  24. Drug Information Provided by Lexi-Comp by the Merck Manuals.
  25. Nebulized colistin causes chest tightness in adults with cystic fibrosis. Respir Med 1994;88:145-7.
  26. Cure of post-traumatic recurrent multiresistant Gram-negative rod meningitis with intraventricular colistin. J Infect 2005;50:348-52.
  27. Treatment of nosocomial meningitis due to multidrug resistant Acinetobacter baumanii with intraventricular colistin. Saudi Med J 2005;26:656-8.
  28. Intrathecal use of colistin. J Clin Microbiol 2000;38:3523.
  29. Neurotoxic and nephrotoxic effects of colistin in patients with renal disease. N Engl J Med 1962;266:759-62.
  30. Adverse effects of sodium colistimethate. Manifestations and specific reaction rates during 317 courses of therapy. Ann Intern Med 1970;72:857-68.
  31. Chemical alterations in cell envelopes of polymyxin-resistant Pseudomonas aeruginosa isolates. J Bacteriol 1979;138:839-45.
  32. Evidence of two distinct mechanisms of resistance to polymyxin B in Pseudomonas aeruginosa. Antimicrob Agents Chemother 1984;26:539-45.
  33. Treatment of multidrug-resistant Acinetobacter baumanni ventilator-associated pneumonia (VAP) with intravenous colistin: A comparison with imipenem-susceptible VAP. Clin Infect Dis 2003;36:1111-8.
  34. Safety and efficacy of colistin in Acinetobacter and Pseudomonas infections: A prospective cohort study. Intensive Care Med 2005;31:1058-65.
  35. Intravenous colistin as therapy for nosocomial infections caused by multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. Clin Infect Dis 1999;28:1008-11.
  36. Use of parenteral colistin for the treatment of serious infection due to antimicrobial-resistant Pseudomonas aeruginosa. Clin Infect Dis 2003;37:154-60.
  37. Colistin treatment in patients with ICU-acquired infections caused by multiresistant Gram-negative bacteria: the renaissance of an old antibiotic. Clin Microbiol Infect 2005;11:115-21.
  38. Use of colistin in the treatment of multiple-drug resistant gram-negative infections. Am J Health Syst Pharm 2005;62:39-47.
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