Abstract

A SYSTEMATIC REVIEW ON COLISTIN: RESISTANCE AND CLINICAL USES

Ashitha Ephrem and Mohammad Makhsoos Afsa

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Abstract

It is well known how microbiological diseases were treated in pre historic Egypt, Greece, and china. With the discovery of penicillin by Sir Alexander Fleming in 1928, the modern era of antibiotics began. A 1947 discovery of the Gram-positive bacterium Paenibacillus polymyxa led to the isolation of colistin from soil organisms. There are a number of ways for gram-negative bacteria to defend themselves from colistin and other polymyxins. Colistin has been used to treat infectious disorders brought on by Gram-negative bacteria since 1959.Colistin has a limited range of antibacterial activity; it has been shown to be effective in vitro against several MDR Gram-negative pathogens, such as the prevalent or significant non-fermentative Gramnegative bacteria A. baumannii and P. Aeruginosa. Only a few studies have properly assessed the effectiveness of combining colistin (sulphate) or colistimethate (sodium) with other antibiotics. Studies covering 860 individuals with Gram-negative infections contributed information on the colistin dose regimen for this systematic review. The typical dose of CBA indicated by manufacturers in the USA was 2.5–5 mg/kg/day. There have been numerous cases of nephrotoxicity and neurotoxicity associated with the early use of colistin. Despite the alarming resistance to many other currently available antibiotics, colistin has been used more frequently for multidrug-resistant Gram-negative bacterial infections. This antibiotic should be administered in accordance with the patient's weight and renal function.

Keywords: Colistin, Resistance, Antibacterial, A. baumannii, P. aeruginosa.