Colistimethate Sodium for Injection I.P.

The following criteria has been proposed for initiating Colistin

For I.V Use Only

  1. Pan-resistant organism as per culture report with evidence of invasive disease – fever/ leucocytosis/elevated procalcitonin (PCT) or culture from a sterile site.
  2. Clinical failure of all other classes of antibiotics over 72 hours

In case of Pan drug resistant Pseudomonas /Acinetobacter spp. combination therapy using colistin along with beta-lactams (using PK/PD principles) should be discussed

Inherently resistant organisms:

  • Brucella species
  • Burkholderia cepacia and related species
  • Neisseria species
  • Proteus species
  • Providencia species
  • Serratia species
  • Anaerobes
  • All Gram-positive organisms

Colistin activity equivalent.

  1. 1 mg of CMS = 0.375 mg of colistin base activity = 12,500 IU
  2. 1 mg of colistin base activity = 2.6 mg of CMS = 32,500 IU

In PK/PD studies of colistin, mean maximum serum concentration (Cmax) of colistin were found just above the MIC breakpoint of 2 mg/L (Clinical and Laboratory Standards Institute)