High Colistin Doses Associated with Early Renal Dysfunction

Nephrotoxicity developed in 43% of patients receiving intravenous colistin — usually during the first week of therapy — and was associated with doses ≥5 mg/kg/day of ideal body weight.

The emergence of multidrug-resistant gram-negative organisms has led to increasing use of colistin — an antimicrobial that was abandoned years ago because of its association with renal dysfunction. Recent reports from Europe suggest relatively low rates of nephrotoxicity with this drug (10%–30%), but the doses used there may be lower than those used in the U.S.

To shed additional light on the situation, investigators conducted a retrospective cohort study involving all adults who received intravenous colistin at the Detroit Medical Center between 2005 and 2009. Nephrotoxicity was defined according to RIFLE system criteria.

Among 126 patients, 54 (43%) showed some degree of nephrotoxicity — 42 of them within the first week of colistin therapy.…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)