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Konstantinos Z Vardakas, Konstantinos Rellos, Nikolaos A Triarides, Matthew E Falagas
Colistin (polymyxin E) has been widely used since the beginning of the century as a last-option antibiotic for the treatment of patients with multidrug-resistant and extensively-drug resistant bacterial infections. However, colistin dosing is troublesome because each batch of the drug contains a mixture of components and because it is administered as the inactive pro-drug colistimethate sodium (CMS), which has different pharmacokinetic (PK) properties from the active drug. Significant inter-individual and intra-individual variability in colistin plasma concentrations have been observed in all available studies...
September 28, 2016: International Journal of Antimicrobial Agents
J Stuart Elborn, Anne-Lise Vataire, Ayako Fukushima, Samuel Aballea, Amine Khemiri, Curtis Moore, Goran Medic, Michiel E H Hemels
PURPOSE: In Europe, 4 inhaled antibiotics (tobramycin, colistimethate sodium, aztreonam, and levofloxacin) are currently approved for the treatment of chronic Pseudomonas aeruginosa lung infection in patients with cystic fibrosis (CF). Levofloxacin inhalation solution (LIS) is the most recently approved inhaled antibiotic for adult patients with CF. A systematic literature review and Bayesian network meta-analysis (NMA) was conducted to compare the relative short-term (4 weeks) and long-term (24 weeks) outcomes of these inhaled antibiotics versus LIS...
September 28, 2016: Clinical Therapeutics
Kevin Bihan, Qin Lu, Manon Enjalbert, Maxime Apparuit, Olivier Langeron, Jean-Jacques Rouby, Christian Funck-Brentano, Noël Zahr
BACKGROUND: Colistin is a polypeptide antibiotic from the polymyxin E group used for the treatment of infections caused by multidrug-resistant gram-negative bacteria. The main constituents, accounting for approximately 85% of this mixture, are colistin A (polymyxin E1) and colistin B (polymyxin E2). The aim of this study was to develop and validate new and fast methods of quantification of colistin A and B and its precursors [colistin methanesulfonate sodium (CMS) A and B] by ultraperformance liquid chromatography-tandem mass spectrometry in plasma and urine with short pretreatment and run times...
December 2016: Therapeutic Drug Monitoring
M Moreno-Sastre, M Pastor, A Esquisabel, E Sans, M Viñas, D Bachiller, J L Pedraz
In the last decades, the encapsulation of antibiotics into nanoparticulate carriers has gained increasing attention for the treatment of infectious diseases. Sodium colistimethate-loaded solid lipid nanoparticles (Colist-SLNs) and nanostructured lipid carriers (Colist-NLCs) were designed aiming to treat the pulmonary infection associated to cystic fibrosis patients. The nanoparticles were freeze-dried using trehalose as cryoprotectant. The stability of both nanoparticles was analysed over one year according to the International Conference of Harmonisation (ICH) guidelines by determining the minimum inhibitory concentration (MIC) against clinically isolated Pseudomonas aeruginosa strains and by studying their physico-chemical characteristics...
October 14, 2016: Journal of Microencapsulation
Mengqiao Wang, Miao Xu, Yan Long, Sonia Fargue, Noel Southall, Xin Hu, John C McKew, Christopher J Danpure, Wei Zheng
Glycolate oxidase (GO) and alanine:glyoxylate aminotransferase (AGT) are both involved in the peroxisomal glyoxylate pathway. Deficiency in AGT function causes the accumulation of intracellular oxalate and the primary hyperoxaluria type 1 (PH1). AGT enhancers or GO inhibitors may restore the abnormal peroxisomal glyoxylate pathway in PH1 patients. With stably transformed cells which mimic the glyoxylate metabolic pathway, we developed an indirect glycolate cytotoxicity assay in a 1,536-well plate format for high throughput screening...
September 27, 2016: Scientific Reports
Anxo Fernández-Ferreiro, Miguel González-Barcia, María Gil-Martínez, María Santiago Varela, María Pardo, José Blanco-Méndez, Antonio Piñeiro-Ces, María Jesús Lamas Díaz, Francisco J Otero-Espinar
The use of parenteral antibiotic eye drop formulations with non-marketed compositions or concentrations, commonly called fortified antibiotic eye drops, is a common practice in Ophthalmology in the hospital setting. The aim of this study was to evaluate the in vitro ocular toxicity of the main fortified antibiotic eye drops prepared in the Hospital Pharmacy Departments. We have conducted an in vitro experimental study in order to test the toxicity of gentamicin, amikacin, cefazolin, ceftazidime, vancomycin, colistimethate sodium and imipenem-cilastatin eye drops; their cytotoxicity and acute tissue irritation have been evaluated...
September 2016: Farmacia Hospitalaria
Maria F Mojica, Christopher P Ouellette, Amy Leber, M Brian Becknell, Monica I Ardura, Federico Perez, Masako Shimamura, Robert A Bonomo, Samuel L Aitken, Samuel A Shelburne
Stenotrophomonas maltophilia is an emerging multidrug-resistant (MDR) opportunistic pathogen for which new antibiotic options are urgently needed. We report our clinical experience treating a 19-year-old renal transplant recipient who developed prolonged bacteremia due to metallo-β-lactamase-producing S. maltophilia refractory to conventional treatment. The infection recurred despite a prolonged course of colistimethate sodium (colistin) but resolved with the use of a novel drug combination with clinical efficacy against the patient's S...
September 2016: Antimicrobial Agents and Chemotherapy
Kady Phe, Ryan K Shields, Frank P Tverdek, Samuel L Aitken, David J Guervil, Wai-Ying M Lam, Rachel J Musgrove, Andrea M Luce, Vincent H Tam
OBJECTIVES: With increasing rates of infections caused by MDR Gram-negative organisms, clinicians resort to older agents such as colistimethate sodium (CMS) despite a significant risk of nephrotoxicity. Several risk factors for CMS-associated nephrotoxicity have been reported, but they have yet to be validated. We compared the performance of published mathematical models in predicting the risk of CMS-associated nephrotoxicity. METHODS: In a multicentre, retrospective, cohort study, adult patients (≥18 years of age) were evaluated from five large academic medical centres in the USA...
August 19, 2016: Journal of Antimicrobial Chemotherapy
Veronica Chorro-Mari, Nanna Christiansen
AIM: Due to national changes to the commissioning process of high cost nebulisers (HCN) for Cystic Fibrosis (CF) patients, CF centres have to repatriate the prescribing of the HCN to the tertiary care centres.1 The following nebulisers will no longer be prescribed by primary care: Cayston® (Aztreonam); Colomycin®, Pomixin®, Clobreathe® (Colistimethate); Pulmozyme® (Dornase alfa); Tobi®, Tobi Podhaler ®, Bramitob® (Tobramycin).This abstract explains how the Royal London Hospital (RLH) Paediatric Pharmacy recruited over 100 paediatric (CF) patients smoothly within a period of 4 months and set up a homecare system to avoid patients and families having to travel large distances to obtain their medication...
September 2016: Archives of Disease in Childhood
Daniel L Hamilos
Chronic rhinosinusitis (CRS) is highly prevalent in patients with cystic fibrosis (CF) and accounts for significant morbidity and contribution to CF lung disease. Mutations of the cystic fibrosis transmembrane regulator gene occur with increased prevalence in patients with CRS without CF, suggesting some contribution to CRS pathophysiology. Nasal polyps (NPs) occur with increased prevalence in patients with CF of all ages and have a more neutrophilic appearance with fewer eosinophils and increased submucosal glandular elements in comparison to NPs from patients without CF...
July 2016: Journal of Allergy and Clinical Immunology in Practice
D E Katz, D Marchaim, M V Assous, A Yinnon, Y Wiener-Well, E Ben-Chetrit
OBJECTIVE: At the Shaare Zedek Medical Center, we have been using colistimethate sodium (CMS) for empiric as well as pathogen-directed treatment. We present our 10-year experience. METHODS: We conducted a retrospective case-series analysis of patients admitted from 1 January 2004 through 1 May 2014 who received at least one dose of CMS. Patient characteristics analysed for all admission for which patients received CMS, included: age, number of re-admissions, admission ward, renal function, disposition and microbiology results...
September 2016: International Journal of Clinical Practice
Narongsak Nakwan, Siripa Usaha, Kulkanya Chokephaibulkit, Paola Villani, Mario Regazzi, Roberto Imberti
In this study we sought to evaluate the pharmacokinetics of colistin following intravenous (iv) administration of colistimethate sodium (CMS) in the critically ill neonates with Gram-negative bacterial infections. A single iv dose of CMS (approximately 150,000 IU/kg, equivalent to 5 mg/kg colistin base activity (CBA) was administered to 7 critically ill neonates. Mean (±SD) maximum plasma colistin concentration (Cmax) and area under the time-concentration curve from 0 to infinity (AUC0-∞) were 3.0 ± 0...
June 7, 2016: Pediatric Infectious Disease Journal
Samrat Chatterjee, Deepshikha Agrawal
The purpose was to evaluate the clinical outcome in multi-drug resistant Pseudomonas aeruginosa (MDR-PA) bacterial keratitis and report the successful use of an alternative antibiotic, topical colistimethate in some of them. The medical records of 12 culture-proven MDR-PA keratitis patients, all exhibiting in vitro resistance by Kirby-Bauer disc diffusion method to ≥ three classes of routinely used topical antibiotics were reviewed. Eight patients were treated with 0.3% ciprofloxacin or ofloxacin, 1 patient with 5% imipenem/cilastatin and 3 patients with 1...
February 2016: Indian Journal of Ophthalmology
Réka Bodnár, Ágnes Mészáros, Máté Oláh, Tamás Ágh
BACKGROUND: Inhaled antibiotics (ABs) are recommended for use in the therapy of chronic Pseudomonas aeruginosa infection in patients with cystic fibrosis (CF). The aim of this systematic literature review was to identify level of adherence to inhaled ABs and to determine predictors and consequences of nonadherence in CF. METHODS: A systematic literature search of English-language articles was conducted in April 2015 using Medline and Embase. No publication date limit was applied...
2016: Patient Preference and Adherence
Ahlem Trifi, Sami Abdellatif, Foued Daly, Khaoula Mahjoub, Rochdi Nasri, Mouna Oueslati, Rahma Mannai, Montassar Bouzidi, Salah Ben Lakhal
BACKGROUND: Colistimethate sodium (CMS) is the commercialized form of colistin that is effective against multiresistant Gram-negative bacilli. Its main side effects are nephrotoxicity and neurotoxicity. Pharmacodynamic dosages showed that they were infratherapeutic. Therefore, strategies with higher doses were proposed. The aim of this study was to assess the efficiency and toxicity of higher-dose CMS by comparing two treatment strategies: high-dose CMS versus standard-dose CMS. METHODS: A prospective and comparative study of two matched groups was conducted...
2016: Chemotherapy
Maria Helena Rigatto, Maura S Oliveira, Lauro V Perdigão-Neto, Anna S Levin, Claudia M Carrilho, Marcos Toshiyuki Tanita, Felipe F Tuon, Douglas E Cardoso, Natane T Lopes, Diego R Falci, Alexandre P Zavascki
Nephrotoxicity is the main adverse effect of colistin and polymyxin B (PMB). It is not clear whether these two antibiotics are associated with different nephrotoxicity rates. We compared the incidences of renal failure (RF) in patients treated with colistimethate sodium (CMS) or PMB for ≥48 h. A multicenter prospective cohort study was performed that included patients aged ≥18 years. The primary outcome was renal failure (RF) according to Risk, Injury, Failure, Loss, and End-stage renal disease (RIFLE) criteria...
April 2016: Antimicrobial Agents and Chemotherapy
Francesca Buttini, Irene Rossi, Marica Di Cuia, Alessandra Rossi, Gaia Colombo, Lisa Elviri, Fabio Sonvico, Anna Giulia Balducci
In this work different nebulisers were investigated in order to assess their efficiency in combination with colistimethate sodium (CMS) inhalation products. Four nebulisers, namely I-neb(®), Aeroneb(®) Go, eFlow(®)rapid and PARI LC(®) Sprint were studied in terms of delivered dose (DD), drug delivery rate (DDR) and respirable dose (RD) of CMS. The goal was to provide scientific data to physicians for prescribing the most appropriate nebuliser for the CMS specific user. All the apparatuses nebulised ColiFin 1MIU/3 ml solution (80 mg of CMS) with delivered doses between 31% and 41% of the loaded amount...
April 11, 2016: International Journal of Pharmaceutics
Shankha Subhra Nag, Abhijit Dutta, Piyali Mitra, Rahul Majumdar, Mridula Chatterjee
No abstract text is available yet for this article.
August 2016: Indian Journal of Pediatrics
David Collie, Laura Glendinning, John Govan, Steven Wright, Elisabeth Thornton, Peter Tennant, Catherine Doherty, Gerry McLachlan
BACKGROUND: Exacerbations associated with chronic lung infection with Pseudomonas aeruginosa are a major contributor to morbidity, mortality and premature death in cystic fibrosis. Such exacerbations are treated with antibiotics, which generally lead to an improvement in lung function and reduced sputum P. aeruginosa density. This potentially suggests a role for the latter in the pathogenesis of exacerbations. However, other data suggesting that changes in P. aeruginosa sputum culture status may not reliably predict an improvement in clinical status, and data indicating no significant changes in either total bacterial counts or in P...
2015: PloS One
Yiying Cai, Winnie Lee, Andrea L Kwa
Polymyxin B and colistin (polymyxin E) are polypeptide antibiotics that were developed in the 1940s, but fell into disfavor due to their high toxicity rates. These two antibiotics were previously regarded to be largely equivalent, due to similarities in their chemical structure and spectrum of activity. In recent years, several pertinent differences, especially in terms of potency and disposition, have been revealed between polymyxin B and colistin. These differences are mainly attributed to the fact that polymyxin B is administered parenterally in its active form, while colistin is administered parenterally as an inactive pro-drug, colistimethate...
2015: Expert Review of Anti-infective Therapy
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