Dose Optimization of Colistin: A Systematic Review

Colistin is considered a last treatment option for multi-drug and extensively resistant Gram-negative infections. We aimed to assess the available data on the dosing strategy of colistin. A systematic review was performed to identify all published studies on the dose optimization of colistin. Grey l...

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Published inAntibiotics (Basel) Vol. 10; no. 12; p. 1454
Main Authors Haseeb, Abdul, Faidah, Hani Saleh, Alghamdi, Saleh, Alotaibi, Amal F., Elrggal, Mahmoud Essam, Mahrous, Ahmad Jamal, Almarzoky Abuhussain, Safa S., Obaid, Najla A., Algethamy, Manal, AlQarni, Abdullmoin, Khogeer, Asim A., Saleem, Zikria, Sheikh, Aziz
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 26.11.2021
MDPI
Subjects
Antibiotics
Bacterial diseases
Bacterial infections
Case reports
Clinical outcomes
Clinical trials
Colistin
Data search
Dosage
dose optimization
Drug dosages
Drug resistance
Gram-negative bacteria
Gram-negative infections
Infections
Maintenance
nephrotoxicity
Optimization
Patients
Pediatrics
Pharmacokinetics
Plasma
Regulatory approval
Reviews
Systematic Review
dose optimization
nephrotoxicity
Gram-negative infections
colistin
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Abstract Colistin is considered a last treatment option for multi-drug and extensively resistant Gram-negative infections. We aimed to assess the available data on the dosing strategy of colistin. A systematic review was performed to identify all published studies on the dose optimization of colistin. Grey literature and electronic databases were searched. Data were collected in a specified form and the quality of the included articles was then assessed using the Newcastle-Ottawa scale for cohort studies, the Cochrane bias tool for randomized clinical trials (RCT), and the Joanna Briggs Institute (JBI) critical checklist for case reports. A total of 19 studies were included, of which 16 were cohort studies, one was a RCT, and two were case reports. A total of 18 studies proposed a dosing regimen for adults, while only one study proposed a dosing schedule for pediatric populations. As per the available evidence, a loading dose of 9 million international units (MIU) of colistin followed by a maintenance dose of 4.5 MIU every 12 h was considered the most appropriate dosing strategy to optimize the safety and efficacy of treatment and improve clinical outcomes. This review supports the administration of a loading dose followed by a maintenance dose of colistin in severe and life-threatening multi-drug Gram-negative bacterial infections.
AbstractList Colistin is considered a last treatment option for multi-drug and extensively resistant Gram-negative infections. We aimed to assess the available data on the dosing strategy of colistin. A systematic review was performed to identify all published studies on the dose optimization of colistin. Grey literature and electronic databases were searched. Data were collected in a specified form and the quality of the included articles was then assessed using the Newcastle-Ottawa scale for cohort studies, the Cochrane bias tool for randomized clinical trials (RCT), and the Joanna Briggs Institute (JBI) critical checklist for case reports. A total of 19 studies were included, of which 16 were cohort studies, one was a RCT, and two were case reports. A total of 18 studies proposed a dosing regimen for adults, while only one study proposed a dosing schedule for pediatric populations. As per the available evidence, a loading dose of 9 million international units (MIU) of colistin followed by a maintenance dose of 4.5 MIU every 12 h was considered the most appropriate dosing strategy to optimize the safety and efficacy of treatment and improve clinical outcomes. This review supports the administration of a loading dose followed by a maintenance dose of colistin in severe and life-threatening multi-drug Gram-negative bacterial infections.Colistin is considered a last treatment option for multi-drug and extensively resistant Gram-negative infections. We aimed to assess the available data on the dosing strategy of colistin. A systematic review was performed to identify all published studies on the dose optimization of colistin. Grey literature and electronic databases were searched. Data were collected in a specified form and the quality of the included articles was then assessed using the Newcastle-Ottawa scale for cohort studies, the Cochrane bias tool for randomized clinical trials (RCT), and the Joanna Briggs Institute (JBI) critical checklist for case reports. A total of 19 studies were included, of which 16 were cohort studies, one was a RCT, and two were case reports. A total of 18 studies proposed a dosing regimen for adults, while only one study proposed a dosing schedule for pediatric populations. As per the available evidence, a loading dose of 9 million international units (MIU) of colistin followed by a maintenance dose of 4.5 MIU every 12 h was considered the most appropriate dosing strategy to optimize the safety and efficacy of treatment and improve clinical outcomes. This review supports the administration of a loading dose followed by a maintenance dose of colistin in severe and life-threatening multi-drug Gram-negative bacterial infections.
Colistin is considered a last treatment option for multi-drug and extensively resistant Gram-negative infections. We aimed to assess the available data on the dosing strategy of colistin. A systematic review was performed to identify all published studies on the dose optimization of colistin. Grey literature and electronic databases were searched. Data were collected in a specified form and the quality of the included articles was then assessed using the Newcastle-Ottawa scale for cohort studies, the Cochrane bias tool for randomized clinical trials (RCT), and the Joanna Briggs Institute (JBI) critical checklist for case reports. A total of 19 studies were included, of which 16 were cohort studies, one was a RCT, and two were case reports. A total of 18 studies proposed a dosing regimen for adults, while only one study proposed a dosing schedule for pediatric populations. As per the available evidence, a loading dose of 9 million international units (MIU) of colistin followed by a maintenance dose of 4.5 MIU every 12 h was considered the most appropriate dosing strategy to optimize the safety and efficacy of treatment and improve clinical outcomes. This review supports the administration of a loading dose followed by a maintenance dose of colistin in severe and life-threatening multi-drug Gram-negative bacterial infections.
Author Obaid, Najla A.
Mahrous, Ahmad Jamal
Alghamdi, Saleh
Faidah, Hani Saleh
Algethamy, Manal
Elrggal, Mahmoud Essam
Saleem, Zikria
AlQarni, Abdullmoin
Khogeer, Asim A.
Sheikh, Aziz
Haseeb, Abdul
Alotaibi, Amal F.
Almarzoky Abuhussain, Safa S.
AuthorAffiliation 10 Usher Institute, The University of Edinburgh, Teviot Place, Edinburgh EH16 4UX, UK; aziz.sheikh@ed.ec.uk
5 Alnoor Specialist Hospital, Department of Infection Prevention & Control Program, Makkah 24382, Saudi Arabia; mmalgethamy@moh.gov.sa
7 Plan and Research Department, General Directorate of Health Affairs of Makkah Regiona, Ministry of Health, Makkah 24382, Saudi Arabia; akhogeer@moh.gov.sa
3 Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Al Baha University, Al Baha 65779, Saudi Arabia; saleh.alghamdi@bu.edu.sa
8 Medical Genetics Unit, Maternity & Children Hospital, Makkah Healthcare Cluster, Ministry of Health, Makkah 24382, Saudi Arabia
6 Alnoor Specialist Hospital, Infectious Diseases Department, Makkah 24382, Saudi Arabia; al-qrni@hotmail.com
2 Department of Microbiology, Faculty of Medicine, Umm Al Qura University, Makkah 24382, Saudi Arabia; hsfaidah@uqu.edu.sa
4 Department of Pharmaceutics, College of Pharmacy, Umm Al Qura University, Makkah 24382, Saudi Arabia; n
AuthorAffiliation_xml – name: 5 Alnoor Specialist Hospital, Department of Infection Prevention & Control Program, Makkah 24382, Saudi Arabia; mmalgethamy@moh.gov.sa
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– name: 4 Department of Pharmaceutics, College of Pharmacy, Umm Al Qura University, Makkah 24382, Saudi Arabia; naobaid@uqu.edu.sa
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Keywords dose optimization
nephrotoxicity
Gram-negative infections
colistin
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Snippet Colistin is considered a last treatment option for multi-drug and extensively resistant Gram-negative infections. We aimed to assess the available data on the...
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StartPage 1454
SubjectTerms Antibiotics
Bacterial diseases
Bacterial infections
Case reports
Clinical outcomes
Clinical trials
Colistin
Data search
Dosage
dose optimization
Drug dosages
Drug resistance
Gram-negative bacteria
Gram-negative infections
Infections
Maintenance
nephrotoxicity
Optimization
Patients
Pediatrics
Pharmacokinetics
Plasma
Regulatory approval
Reviews
Systematic Review
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Title Dose Optimization of Colistin: A Systematic Review
URI https://www.ncbi.nlm.nih.gov/pubmed/34943666
https://www.proquest.com/docview/2612726956
https://www.proquest.com/docview/2614245719
https://pubmed.ncbi.nlm.nih.gov/PMC8698549
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Volume 10
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