Colistimethate Sodium
Colistimethate sodium (colistin polymyxin E) is a polymyxin antibiotic administered parenterally or by inhalation. It acts as a surfactant that penetrates and disrupts the bacterial outer and cytoplasmic membranes of Gram-negative bacteria, causing leakage of intracellular contents and cell death. Due to risk of nephrotoxicity and neurotoxicity, its systemic use is generally reserved for multi-drug resistant infections.
Dosage by Body Weight
Parenteral dosage is based on Colistin Base Activity (CBA) or International Units (IU). Pediatric dose with normal renal function is typically 2.5 to 5 mg/kg/day of CBA (75,000 to 150,000 IU/kg/day) divided into 3 doses administered intravenously. Daily maximum is typically 5 mg/kg/day of CBA. Strict dose adjustment is required in patients with renal impairment.
- Body Weight
- Below 5 kg
- Dose
- Not routine
- Frequency
- Use only if prescribed
- Tracking Notes
- Extreme caution required in neonates and infants due to immature renal function. If essential, dose is 2.5 to 5 mg/kg/day CBA divided every 8 to 12 hours with close therapeutic drug monitoring.
- Body Weight
- 5-7 kg
- Dose
- 12.5 mg to 35 mg of Colistin Base Activity (CBA) per day
- Frequency
- Divided every 8 hours
- Tracking Notes
- Corresponds to approximately 2.5 to 5 mg/kg/day of CBA. Monitor renal function closely and maintain adequate hydration.
- Body Weight
- 8-10 kg
- Dose
- 20 mg to 50 mg of Colistin Base Activity (CBA) per day
- Frequency
- Divided every 8 hours
- Tracking Notes
- Administer intravenously over 30 to 60 minutes. Monitor serum creatinine and urine output.
- Body Weight
- 11-15 kg
- Dose
- 27.5 mg to 75 mg of Colistin Base Activity (CBA) per day
- Frequency
- Divided every 8 hours
- Tracking Notes
- Adjust dosage down immediately if there is any sign of developing nephrotoxicity or decreased renal clearance.
- Body Weight
- 16-20 kg
- Dose
- 40 mg to 100 mg of Colistin Base Activity (CBA) per day
- Frequency
- Divided every 8 hours
- Tracking Notes
- Do not exceed 5 mg/kg/day of CBA. Ensure serum level monitoring if available, especially during prolonged therapy.
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | Not routine | Use only if prescribed | Extreme caution required in neonates and infants due to immature renal function. If essential, dose is 2.5 to 5 mg/kg/day CBA divided every 8 to 12 hours with close therapeutic drug monitoring. |
| 5-7 kg | 12.5 mg to 35 mg of Colistin Base Activity (CBA) per day | Divided every 8 hours | Corresponds to approximately 2.5 to 5 mg/kg/day of CBA. Monitor renal function closely and maintain adequate hydration. |
| 8-10 kg | 20 mg to 50 mg of Colistin Base Activity (CBA) per day | Divided every 8 hours | Administer intravenously over 30 to 60 minutes. Monitor serum creatinine and urine output. |
| 11-15 kg | 27.5 mg to 75 mg of Colistin Base Activity (CBA) per day | Divided every 8 hours | Adjust dosage down immediately if there is any sign of developing nephrotoxicity or decreased renal clearance. |
| 16-20 kg | 40 mg to 100 mg of Colistin Base Activity (CBA) per day | Divided every 8 hours | Do not exceed 5 mg/kg/day of CBA. Ensure serum level monitoring if available, especially during prolonged therapy. |
Formulation
Purpose
Treatment of severe acute or chronic infections caused by susceptible Gram-negative bacilli, particularly multidrug-resistant Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii, when other safer alternatives are ineffective or contraindicated.
Generic Name
Colistimethate SodiumBranded Drug Names
Colistimethate Sodium is listed as a generic drug name. Common branded medicines that may contain the same active ingredient include:
Scheduled Drug
Yes. This medicine should be supplied or used only according to applicable prescription and regulatory requirements.