Colistin pharmacokinetics

During treatment with any of the polymyxins, neurotoxicity can occur in up to 7% of patients with normal renal function. Circumoral paresthesia, vasomotor instability, ataxia, dizziness, convulsions of varying severity, and apnea have been reported. Of 31 patients with cystic fibrosis 21 had one or more adverse effects attributed to colistin (14). The most common reactions involved reversible neurological effects, including oral and perioral paresthesia (n = 16), headache (n = 5), and lower limb weakness (n = 5). All of these effects, although bothersome, were benign and reversible. There was no relation between the occurrence of any colistin-associated adverse effect and plasma colistin concentration or colistin pharmacokinetics. 

Intermittent proteinuria was observed on urinalysis in 14 of 31 patients with cystic fibrosis, and one patient developed reversible, colistin-induced nephrotoxicity (14). There was no relation between the occurrence of any colistin-associated adverse effect and plasma colistin concentration or colistin pharmacokinetics. 

Jimenez-Mejias ME, Pichardo-Guerrero C, Marquez-Rivas FJ, Martin-Lozano D, Prados T, Pachon J. Cerebrospinal fluid penetration and pharmacokinetic/phar-macodynamic parameters of intravenously administered colistin in a case of multidrug-resistant Acinetobacter bau-mannii meningitis. Eur J CUn Microbiol Infect Dis 2002 21(3) 212-14. 

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