TY - JOUR
T1 - Dose Optimization of Colistin: A Systematic Review
AU - Haseeb, Abdul
AU - Faidah, Hani Saleh
AU - Alghamdi, Saleh
AU - Alotaibi, Amal F.
AU - Elrggal, Mahmoud Essam
AU - Mahrous, Ahmad Jamal
AU - Almarzoky Abuhussain, Safa S.
AU - Obaid, Najla A.
AU - Algethamy, Manal
AU - Alqarni, Abdullmoin
AU - Khogeer, Asim A.
AU - Saleem, Zikria
AU - Sheikh, Aziz
PY - 2021/11/26
Y1 - 2021/11/26
N2 - 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.
AB - 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.
U2 - 10.3390/antibiotics10121454
DO - 10.3390/antibiotics10121454
M3 - Article
SN - 2079-6382
VL - 10
SP - 1454
JO - Antibiotics
JF - Antibiotics
IS - 12
ER -