Colistin Dosing in Critically Ill Adults

A Retrospective Observational Study

An old antibiotic, Colistin has regained importance in the last decade owing to the rising challenge of multi-drug resistance in Gram-negative bacteria. However, its narrow therapeutic index mandates an accurate dosing regimen. In this newly published retrospective propensity-score-matched study comparing twice-a-day and thrice-a-day administration of a fixed total daily dose of Colistin in critically ill adults, we found that the twice-a-day administration is associated with less acute kidney injury events and similar clinical outcomes as thrice-a-day regimen. We hypothesise that this is related to the tendency of Colistin to accumulate in the proximal renal tubules and the twice-a-day regimen allows a longer wash-out period.

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