Abstract
Colistin is used as a last-line antibiotic for the treatment of Gram-negative multiresistant bacteria. Due to its high nephrotoxicity, Therapeutic Drug Monitoring (TDM) is recommended for dose adjustment. We aimed to evaluate the available evidence of TDM in patients given colistin to treat Gram-negative infections. In this paper, we offer an overview, using an electronic search of the literature (published up to June 2019, without language restrictions) that compares the clinical outcomes and measurements of colistin TDM. Ultimately, the Therapeutic Drug Monitoring (TDM) of colistin in Plasma could prevent nephrotoxicity risk.
Highlights
Multidrug-resistant (MDR) infections have emerged as a treatment challenge [1]
Falagas et al reviewed this classification’s variability in the pertinent literature, especially regarding Pseudomonas aeruginosa and Acinetobacter baumannii. Most define their resistance profiles as resistance to three or more classes of antibiotics [2]. Another categorization of this resistance phenomenon is illustrated by resistance to a key antimicrobial, such as Staphylococcus aureus, where resistance to methicillin represents a multi-resistance pattern [3]
New antibiotics are commercially available with in vitro activity for resistant Gram-positive organisms, such as vancomycin-resistant Enterococci and methicillin-resistant S. aureus, a limited armamentarium continues to exist for MDR Gram-negative infections, and the industry has been reluctant to invest in the research and development of these types of antibiotics [1]
Summary
Multidrug-resistant (MDR) infections have emerged as a treatment challenge [1]. MDR literally refers to resistance to more than one antimicrobial agent; different reviews to date have been ambiguous when specifying/concretizing this definition. Falagas et al reviewed this classification’s variability in the pertinent literature, especially regarding Pseudomonas aeruginosa and Acinetobacter baumannii. Most define their resistance profiles as resistance to three or more classes of antibiotics [2]. Another categorization of this resistance phenomenon is illustrated by resistance to a key antimicrobial, such as Staphylococcus aureus, where resistance to methicillin represents a multi-resistance pattern [3]. New antibiotics are commercially available with in vitro activity for resistant Gram-positive organisms, such as vancomycin-resistant Enterococci and methicillin-resistant S. aureus, a limited armamentarium continues to exist for MDR Gram-negative infections, and the industry has been reluctant to invest in the research and development of these types of antibiotics [1]
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