Colistin is an antibiotic drug to treat infectious diseases caused by Gram negative bacteria, such as Escherichia coli , Klebsiella pneumoniae , Acinetobacter , and Pseudomonas aeruginosa.

Colistin belongs to the class of polypeptide antibiotics. This drug can be divided into 2 types, namely colistimethate sodium and colistin sulfate . Colistin sulphate is available as a tablet orally or inhaled and colistemethate sodium is available as an injection or inhaled.

This drug works by damaging the bacterial cell membrane. That way, the bacteria will stop growing and eventually die. This medicine cannot be used to treat diseases caused by viral infections, such as the flu.

Some of the diseases that can be treated by this drug are digestive tract infections, or lung infections in cystic fibrosis patients.

Colistin trademark:  Colistine actavis

What is Colistin

class Prescription drug
Category Polypeptide class of antibiotics
Benefit Treats bacterial infections
Consumed by Adults and children
Colistin for pregnant and lactating women Category C:  Studies in animal studies have shown an adverse effect on the fetus, but there have been no controlled studies in pregnant women. The drug should only be used if the expected benefit outweighs the risk to the fetus.

It is not known whether Colistin is absorbed into breast milk or not. If you are breastfeeding, do not use this medicine without telling your doctor.

Drug form Tablets, snorts and injections

Precautions Before Using Colistin

Colistin should only be used with a doctor's prescription. Before using colistin, you need to pay attention to the following things:

  • Do not use colistin if you are allergic to this drug or to polymyxin B. Always tell your doctor about any allergies you have.
  • Tell your doctor if you have had or currently have  kidney disease , diarrhoea, myasthenia gravis , colitis, porphyria , or lung disease.
  • Do not drive a vehicle or operate equipment that requires vigilance while taking colistin, as this medicine can cause dizziness.
  • Tell your doctor if you are pregnant, breastfeeding, or planning a pregnancy.
  • Tell your doctor if you are taking certain medications, supplements or herbal products.
  • Tell your doctor if you plan to get vaccinated while on treatment with colistin.
  • See your doctor immediately if you experience a drug allergic reaction , serious side effects, or overdose, after using colistin.

Dosage and Rules of Use Colistin

The doctor will give the dose and determine the duration of treatment according to the condition and age of the patient. Here is the explanation:

Condition: Severe gram negative bacterial infection

Form: Injections can be given into a muscle (intramuscular/IM) or into a vein (intravenous/IV)

  • Adults weighing ≤60 kg: 50 . 000 IU/kgBB per day which can be divided into 3 times administration. The maximum dose is 75,000 IU/kgBB per day.
  • Adults weighing >60 kg: 1-2 million IU, 3 times daily. The maximum dose is 6 million IU per day.

Condition: Bacterial infection

Shape: Tablet

  • Adults and children weighing >30 kg: 1-2 tablets, 3 times a day.
  • Children weighing 15–30 kg: –1 tablet, 3 times a day.

Condition: Lung infection in cystic fibrosis patient

Shape: Inhale

  • Adults: 1-2 million IU, 2-3 times daily. The maximum dose is 6 million IU per day.
  • Children <2 years: 000–1 million IU, 2 times daily. The maximum dose is 2 million IU per day.

How to Use  Colistin Correctly

Use colistin as recommended by  your doctor or the instructions for use listed on the medicine package. Do not increase or decrease your dose without consulting your doctor first. Colistin injectable form will be given by a doctor or medical personnel under the supervision of a doctor.

Colistin tablets can be taken before or after meals. Take colistin tablets with a glass of water. Do not split, bite, or crush the tablet.

To treat a lung infection in a patient with cystic fibrosis, you will use an inhaled form of colistin with a nebulizer . Follow your doctor's instructions and make sure you understand how to use the nebulizer.

Take colistin at the same time each day. If you forget to use it, use colistin immediately if the interval for the next use is not too close. If it's close, ignore it and don't double the dose.

Carry out regular check-ups as recommended by your doctor during treatment with colistin. Do not stop using colistin without consulting your doctor first.

Store colistin in a dry, closed place, and away from direct sunlight. Keep this drug out of reach of children.

Colistin Interactions with Other Drugs

There are several drug interaction effects that can occur when colistin is used with other drugs, namely:

  • Increased risk of kidney or neurological disorders when used with aminoglycoside antibiotics, other polypeptide antibiotics, amphotericin B , or cefazedone
  • Increased effectiveness of nondepolarizing muscle relaxants, such as tubocurarine
  • Decreased effectiveness of colistin when used with sodium picosulfate

Colistin Side Effects and Dangers

Some of the side effects that can occur after using colistin are:

  • Stomach ache
  • Hives or rash on the skin

Check with your doctor if the side effects above do not subside or get worse. See your doctor right away if you have an allergic reaction to a drug or a more serious side effect, such as:

  • Numbness or tingling in the feet, hands or around the mouth
  • Difficulty walking or balance problems
  • Confusion, psychosis , or seizures
  • Slurred speech or weak muscles
  • Dizziness or feeling spinning
  • Infrequent urination or very little urine
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