Review article
Colistin: an old antibiotic for the treatment of new multidrug-resistant bacteria
Blanša Bilić
; Opća bolnica Šibensko-kninske županije
Abstract
The occurrence of new multidrug-resistant (MDR) bacteria has generated an incrasing interest in the old antibiotic colistin who has excellent bactericidal activity against most Gram-negative bacteria. It achieves adequate concentrations in the liver, kidneys, heart, and muscle; while it is poorly distributed to the bones, cerebrospinal fluid, lung parenchyma, and pleural cavity. Recent studies of patients who recived intravenous polymyxins for the treatment of serious P. aeruginosa and A. baumannii infections, have led to the conclusion that these antibiotics have acceptable effectiveness and less toxicity than was reported in old studies. Combination therapy mainly with carbapenems shows synergistic effect. Inhaled colistin has been found promising in the treatment of lung infection due to MDR Gram-negative bacteria. However, resistance to colistin has been increasingly reported worldwide, especially in the Mediterranean countries and South-East Asia.
Keywords
Colistin; MDR Gram-negative bacteria; Pseudomonas; Acinetobacter; combined therapy; resistance
Hrčak ID:
166700
URI
Publication date:
31.12.2015.
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