Skip to main content
SpringerLink
Log in

Colistin and neurotoxicity: recommendations for optimal use in cystic fibrosis patients

  • Case Report
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Case description The use of i.v. colistin reappeared recently for the treatment of multidrug-resistant Gram negative organisms in the intensive care and cystic fibrosis (CF) setting. According to the latest pharmacokinetic data, a loading dose and high antibiotic doses are given. Two cases of adverse events (paraesthesias, bad taste) were observed immediately after the start of infusion of a high dose of i.v. colistin in adult CF patients at the Ghent University Hospital. Conclusion Recommendations for optimal administration of i.v. colistin in adult CF patients are scarce. This article highlights the importance of mode of administration to avoid toxicity and relates it to recent pharmacokinetic/-dynamic literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Falagas ME, Kasiakou SK. Toxicity of polymyxins: a systematic review of the evidence from old and recent studies. Crit Care. 2006;10:R27.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Plachouras D, Karvanen M, Friberg LE, Friberg LE, Papadomichelakis E, Antoniadou A, et al. Population pharmacokinetic analysis of colistin methanesulfonate and colistin after intravenous administration in critically ill patients with infections caused by gram-negative bacteria. Antimicrob Agents Chemother. 2009;53:3430–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Garonzik SM, Li J, Thamlikitkul V, Paterson DL, Shoham S, Jacob J, et al. Population pharmacokinetics of colistin methanesulfonate and formed colistin in critically ill patients from a multicenter study provide dosing suggestions for various categories of patients. Antimicrob Agents Chemother. 2011;55:3284–94.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Grégoire N, Mimoz O, Mégarbane B, Comets E, Chatelier D, Lasocki S, Gauzit R, Balayn D, Gobin P, Marchand S, Couet W. New colistin population pharmacokinetic data in critically ill patients suggesting an alternative loading dose rational. Antimicrob Agents Chemother. 2014;58(12):7324–30.

  5. Reed MD, Stern RC, O’Riordan MA, Blumer JL. The pharmacokinetics of colistin in patients with cystic fibrosis. J Clin Pharmacol. 2001;41:645–54.

    Article  CAS  PubMed  Google Scholar 

  6. Li J, Coulthard K, Milne R, Nation RL, Conway S, Peckham D, et al. Steady-state pharmacokinetics of intravenous colistin methanesulphonate in patients with cystic fibrosis. J Antimicrob Chemother. 2003;52:987–92.

    Article  CAS  PubMed  Google Scholar 

  7. Touw DJ. Clinical pharmacokinetics of antimicrobial drugs in cystic fibrosis. Pharm World Sci. 1998;20:149–60.

    Article  CAS  PubMed  Google Scholar 

  8. Al-Aloul M, Miller H, Alapati S, Stockton PA, Ledson MJ, Walshaw MJ. Renal impairment in cystic fibrosis patients due to repeated intravenous aminoglycoside use. Pediatr Pulmonol. 2005;39:15–20.

    Article  CAS  PubMed  Google Scholar 

  9. Sorlí L, Luque S, Grau S, Berenguer N, Segura C, Montero MM, Alvarez-Lerma F, Knobel H, Benito N, Horcajada JP. Trough colistin plasma level is an independent risk factor for nephrotoxicity: a prospective observational cohort study. BMC Infect Dis. 2013;13:380.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Cheah SE, Bulitta JB, Li J, Nation RL. Development and validation of a liquid chromatography-mass spectrometry assay for polymyxin B in bacterial growth media. J Pharm Biomed Anal. 2014;92:177–82. doi:10.1016/j.jpba.2014.01.015 Epub 2014 Jan 24.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We acknowledge Professor William Couet, Poitiers, France, for his valuable reflection on the possibility to assess pharmacokinetic information.

Funding

None.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Pharmacy Department, Ghent University Hospital, K12 Floor -1, De Pintelaan 185, 9000, Ghent, Belgium

    Barbara O. M. Claus

  2. Department of Internal Medicine, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Sylvia Snauwaert

  3. Cystic Fibrosis Reference Centre, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Filomeen Haerynck, Sabine Van Daele, Frans De Baets & Petra Schelstraete

Authors
  1. Barbara O. M. Claus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sylvia Snauwaert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Filomeen Haerynck
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sabine Van Daele
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Frans De Baets
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Petra Schelstraete
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara O. M. Claus.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Claus, B.O.M., Snauwaert, S., Haerynck, F. et al. Colistin and neurotoxicity: recommendations for optimal use in cystic fibrosis patients. Int J Clin Pharm 37, 555–558 (2015). https://doi.org/10.1007/s11096-015-0077-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-015-0077-4

Keywords

Search

Navigation