Colistimethate Sodium for Injection I.P.
The following criteria has been proposed for initiating Colistin
For I.V Use Only
- Pan-resistant organism as per culture report with evidence of invasive disease – fever/ leucocytosis/elevated procalcitonin (PCT) or culture from a sterile site.
- 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 mg of CMS = 0.375 mg of colistin base activity = 12,500 IU
- 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)
Indications:
- Lower respiratory tract infection
- Urinary tract infection
- When more commonly used
- antibiotics may be contraindicated or resistant