DRUG SUPPLIED DOSE COMMENTS
COLISTIMETHATE (Paeds)
(Coly-mycin, Colistin)

Mechanism of action:

bacteriocidal antibiotic; destabilizes cytoplasmic membrane of gram negative bacteria (Pseudomonas, E coli, Klebsiella)



Ref: 32, 44, 306



Last update: 2022-06-17		 injection: 150 mg/vial

 Via Inhalation:
(for Pseudomonas Infections in Cystic Fibrosis Patients)

< 6 years: 100 mg nebulized BID post physio
>= 6 years: 150 mg nebulized BID post physio

Doses are halved for the eFlow Altera Nebulizer System due to the efficiency of this nebulizer (not a hospital-supplied device; patients may use their own device)

IV:
1 - 1.5 mg/kg/dose IV Q8H. Maximum 100 mg/dose.
 Nephrotoxic and neurotoxic when given systemically.

Spectrum of activity is similar to polymyxin.

Injectable form is used for inhalation: prepare by reconstituting vial with 3 mL of normal saline (= 50 mg/mL).  Further dilute dose with normal saline for nebulization. Stable for 24 hours, refrigerated.

For IV dosing in CF: higher doses 5 - 8 mg/kg/24 hours may be required for resistant organisms, however, higher doses are associated with more severe toxicity.


Standard Prescription:

colistimethate__mg by nebulizor __ (frequency) (post chest physio)

colistimethate__mg IV Q__H (__mg/kg/dose)