Is colistin safe in renal failure?
Colistin is potentially nephrotoxic, but its renal toxicity is usually reversible [7]. Renal impairment on baseline is not a contraindication for colistin administration, but dose adjustment is considered.
Why is colistin nephrotoxic?
The mechanism of nephrotoxicity is via an increase in tubular epithelial cell membrane permeability, which results in cation, anion and water influx leading to cell swelling and cell lysis. There are also some oxidative and inflammatory pathways that seem to be involved in colistin nephrotoxicity.
Does colistin increase creatinine?
Renal toxicity is the most common adverse effect of colistin treatment because the drug is excreted primarily by the kidneys and elevated blood levels may further impair renal function….Table 2.
| Category | Criteria |
|---|---|
| Injury (I) | Increased creatinine level × 2 or GFR decrease >50% |
What is EGFR formula?
GFR = 141 × (Scr/0.9)-1.209 × (0.993)Age. CKD-EPI equation expressed as a single equation: GFR = 141 × min (Scr /κ, 1)α × max(Scr /κ, 1)-1.209 × 0.993Age × 1.018 [if female] × 1.159 [if black]
How do you give a colistin nebulizer?
Colistin methanesulfonate was used in all patients. The daily dosage of nebulized colistin was 150 mg divided into 2 doses, and 75 mg of colistin was diluted in 4 mL of sterile normal saline. The solution was nebulized through a conventional nebulizer.
How does colistin work?
Colistin binds to LPSs and phospholipids in the outer cell membrane of Gram-negative bacteria. It competitively displaces divalent cations (Ca2+ and Mg2+) from the phosphate groups of membrane lipids, which leads to disruption of the outer cell membrane, leakage of intracellular contents and bacterial death (Figure 3).
What is the mechanism of action of colistin?
What is colistin used to treat?
Colistin or polymyxin E is an old antibiotic, which has been used since 1959 for treating infection caused by Gram-negative MDRO.
Which drugs are contraindicated in renal failure?
Problematic drugs whose use in patients with renal insufficiency is nephrologically contraindicated: Pethidine, cefepime, lithium, gilbenclamide, gimepiride, metformin, spironolactone, eplerenone, methotrexate, gadolinium, enoxaparin.
What implications will drug dosing have on a person with renal impairment?
Drug dosing errors are common in patients with renal impairment and can cause adverse effects and poor outcomes. Dosages of drugs cleared renally should be adjusted according to creatinine clearance or glomerular filtration rate and should be calculated using online or electronic calculators.