Colistin: Uses, Side Effects & Precautions
For the past fifty years, the inactive prodrug Colistimethate Sodium (colistin methanesulfonate) has been sold alongside colistin (also known as polymyxin E). The medication was one of the first antibiotics to show against Gram-negative bacteria, especially Pseudomonas aeruginosa. It has a rapid bactericidal activity that is concentration-dependent. Bacillus colistin produces a cyclic polypeptide antibiotic. Polymyxins E1 and E2 (also known as Colistins A, B, and C) are detergents that function on cell membranes. Colistin is less toxic than Polymyxin B, but otherwise, they are very similar.
Colistin Uses
- Treats various bacterial infections.
- Used for serious infections not responding to other antibiotics.
- Kills bacteria by destroying the bacterial cell membrane.
- Treats infections of the stomach and intestine caused by sensitive gram-negative bacteria.
- Used for the prevention of bowel sterilization before surgery.
Colistin Side Effects
Common Side Effects:
- Kidney damage
- Diarrhea
- Nausea
- Vomiting
Serious Side Effects:
- Burning or tingling sensation
- Stomach discomfort and cramps
- Weakness in arms, hands, legs, and feet
- Severe difficulty breathing
- Blood in urine
- Skin irritation
Note: If side effects persist or worsen, contact your doctor immediately.
Precautions While Using Colistin
- Inform your doctor if you are allergic to Colistin or related medications.
- May cause serious allergic reactions.
- Discuss any history of kidney disease, liver disease, or nerve/muscle diseases with your doctor.
- Inform your doctor or dentist that you are taking Colistin.
- May affect anesthesia or drugs that obstruct nerve/muscle function.
- Live bacterial vaccines (e.g: typhoid vaccine) may be affected by Colistin; avoid getting vaccinated unless advised by your doctor.
How to Use Colistin Injection?
- Given by injection into the vein or muscle as directed by the doctor.
- Dosage depends on medical condition and response to treatment.
- Learn all preparation and usage instructions from your doctor if administering at home.
Dosage Instructions for Colistin
- Dose: 150 mg (powder for injection)
- Susceptible infections: 2.5 mg/kg/day divided in every 6-12 hours intravenously/ intramuscularly
- Renal Impairment: 2.5-3.8 mg/kg/day IV/IM divided in every 12 hours
Overdose
You may experience symptoms such as stomach ache, nausea, and vomiting if you accidentally took too much of this medication. If you have taken an overdose of the drug, contact your doctor right away or go to the nearest hospital.
Missed Dose
- It is important to take this Colistin Medicine exactly as prescribed in order to get the most benefit. If you miss an injection, call your doctor or pharmacist as soon as possible to set up a new dosing schedule.
- To catch up, do not double the dose. If you forget to take an inhaled dose, do so as soon as possible. If it’s time for the next dose skip the missed dose and take the next dose.
Storage
- Direct contact with heat, air and light may damage your medicines. Exposure to medicine may cause some harmful effects. The medicine must be kept in a safe place and out of children’s reach.
- Mainly, the drug should be kept at room temperature between 68ºF and 77ºF (20ºC and 25ºC).
Warnings for Serious Health Conditions
Neurotoxicity
In certain patients, this medication has been linked to brain injury, memory problems, anxiety, depression, and other psychiatric disorders. Before starting therapy for this drug, tell your doctor if you have ever had a mental disorder.
Pregnancy & Breastfeeding
- If the benefits outweigh the risks, use colistin with caution during pregnancy. Animal studies suggest a risk, but human studies are either unavailable or have not been performed.
- It’s unclear if the drug moves through breast milk or how it could affect a nursing baby. Breastfeeding should be done with caution. Before taking the medication, talk to your doctor if you are breastfeeding.
Colistin vs Meropenem
| Colistin | Meropenem |
| Colistin is an antibiotic that is used for the treatment of various bacterial infections. The drug is used to treat a certain type of serious infection that is not responding to other antibiotics. | Meropenem injection belongs to the antibiotic class of medications. It kills the bacteria that cause infection. |
| The drug is also useful for treating infections of the stomach and the intestine caused due to sensitive gram-negative bacteria and is used for the prevention of bowel sterilization before any surgery is performed. | Meropenem injection is used for treating bacterial skin and abdominal infections, as well as meningitis. |
Some of the common side effects of Colistin are:
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Some common side effects are:
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