Evaluation of colistin as an agent against multi-resistant Gram-negative bacteria

• Published in: International journal of antimicrobial agents 2005, Vol.25 (1), p.11-25
• Main Authors: Li, Jian, Nation, Roger L., Milne, Robert W., Turnidge, John D., Coulthard, Kingsley
• Format: Article
• Language: English
• Subjects: Acinetobacter baumannii; Acinetobacter baumannii - drug effects; Activity; Anti-Bacterial Agents - pharmacokinetics; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Colistin; Colistin - pharmacokinetics; Colistin - pharmacology; Colistin - therapeutic use; Drug Resistance, Multiple, Bacterial; Gram-Negative Bacteria - drug effects; Gram-Negative Bacterial Infections - microbiology; Humans; Klebsiella pneumoniae; Klebsiella pneumoniae - drug effects; Medical sciences; Microbial Sensitivity Tests; Pharmacodynamics; Pharmacokinetics; Pharmacology. Drug treatments; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Resistance
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2004.10.001

Infections caused by multi-resistant Gram-negative bacteria, particularly Pseudomonas aeruginosa, are increasing worldwide. In patients with cystic fibrosis (CF), resistance in P. aeruginosa to numerous anti-pseudomonal agents is becoming common. The absence since 1995, of new substances active against resistant Gram-negative bacteria, has caused increasing concern. Colistin, an old antibiotic also known as polymyxin E, has attracted more interest recently because of its significant activity against multi-resistant P. aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae, and the low resistance rates to it. Because its use as an anti-pseudomonal agent was displaced by the potentially less toxic aminoglycosides in 1970s, our knowledge of this drug is limited. However, there has been a significant recent increase in the data gathered on colistin, focussing on its chemistry, antibacterial activity, mechanism of action and resistance, pharmacokinetics, pharmacodynamics and new clinical application. It is likely that colistin will be an important antimicrobial option against multi-resistant Gram-negative bacteria, for some years to come.