Colistin - Vista is an antibacterial agent for systemic use.
Intravenous use of the drug is indicated for adults and children, including neonates, for the treatment of severe infections caused by selected gram-negative aerobic pathogens in patients with limited treatment options. The drug Colistin-Vista in the form of inhalations is also indicated for adults and children with cystic fibrosis for the treatment of chronic pulmonary infections caused by Pseudomonas aeruginosa.
Mode of application
Adults and teenagers.
Maintenance dose – 9 million IU per day, divided into 2-3 doses. For severely ill patients, a loading dose of 9 million IU should be used. The most appropriate time interval before the first maintenance dose has not been established. Modeling suggests that patients with normal renal function may require loading and maintenance doses of up to 12 million IU in some cases. Clinical experience with such doses, however, is extremely limited, and the safety of their use has not been established.
Instructions for use COLISTAT
Colistat is used parenterally and in the form of inhalations.
Parenteral use
The drug should be administered intravenously in the form of infusions.
The dosage regimen and duration of therapy are determined depending on the type and severity of the infection, the sensitivity of the pathogenic microorganism, the patient's condition, as well as the patient's age, body weight and renal function.
Children and adults (including elderly patients) weighing ≤60 kg
Colistat is prescribed in doses of 50,000-75,000 IU/kg/day. The daily dose should be divided into 3 doses with an interval of 8 hours.
Adults (including elderly patients) weighing >60 kg
Colistat is prescribed in doses of 1,000,000-2,000,000 IU 3 times a day.
Children under 1 year of age
the drug should be administered with caution under close medical supervision.
The maximum daily dose is 6,000,000 IU.
The recommended course of treatment is 5 days. In patients with cystic fibrosis and its exacerbations
bacterial origin, the course of treatment can be 5-12 days.
If the distribution of the drug between tissues in the body is impaired, patients with cystic fibrosis may be prescribed higher doses (but not more than the maximum daily dose) to maintain therapeutic levels in the blood plasma or use the drug in the form of inhalation.
If the clinical or bacteriological effectiveness of Colistat during the first 2-3 days is insufficient, the dose of the drug can be increased depending on the patient’s condition.
In patients with impaired renal function, infants and patients with cystic fibrosis, it is recommended to monitor the concentration of the active substance Colistat in the blood serum. A concentration of 10-15 mg/L (corresponding to approximately 125-200 IU/ml) colistimethate sodium is acceptable for most infections.
For moderate to severe renal impairment
the elimination of colistimethate sodium slows down, so the dose and interval between applications should be adjusted to prevent accumulation of the drug.
The table provides recommendations for dosing of Colistat for patients weighing >60 kg
with impaired renal function. It should be taken into account that further adjustment of the dose of Colistat must be carried out based on the concentration of the active substance in the blood plasma and signs of toxicity.
| Severity of renal dysfunction | CC (ml/min) | Body weight >60 kg |
| Lightweight | 20-50 | 1,000,000-2,000,000 IU, every 8 hours |
| Moderate | 10-20 | 1,000,000 IU, every 12-18 hours |
| Heavy | <10 | 1,000,000 IU, every 18-24 hours |
Inhalation use
For local treatment of lower respiratory tract infections, the drug is used in the form of inhalations.
Children under 2 years of age
Colistat is prescribed at a dose of 500,000-1,000,000 IU 2 times a day.
For children over 2 years of age and adults,
Colistat is prescribed at a dose of 1,000,000-2,000,000 IU 2 times a day.
The course of treatment is determined individually and depends on the clinical condition of the patient. When treating patients with cystic fibrosis
Doses from 500,000 IU 2 times/day to 2,000,000 IU 3 times/day were considered effective and safe.
Rules for preparing and administering the solution
To prepare a solution for intravenous infusion
the contents of the Colistat vial are dissolved in 5 ml of water for injection or 0.9% sodium chloride solution. The solvent should be introduced into the vial slowly, gently shaking the vial until a clear solution is formed, avoiding the appearance of foam. The resulting solution is diluted to 200-500 ml using water for injection or 0.9% sodium chloride solution and mixed. The prepared solution is administered as an intravenous infusion over 30 minutes.
In patients with a fully implanted venous access device (TIVAD), a bolus injection of Colistat (up to 2,000,000 IU dissolved in 10-20 ml) can be used over at least 5 minutes.
The solution must be used immediately after preparation. The unused remainder of the solution must be disposed of.
To avoid administering a dose less than required, make sure that the drug is completely dissolved. The prepared solution should be carefully removed from the bottle.
To prepare a solution for inhalation
the contents of the bottle are pre-dissolved in 3 ml of 0.9% sodium chloride solution or water for injection. The required amount of the prepared solution is poured into a sprayer, which is connected to the air/oxygen supply device, and used according to the instructions for using the device.
For the use of antibiotics in the form of inhalations, nebulizers (jet type or ultrasonic) are recommended, which, when used with an appropriate compressor, create inhalable particles with a diameter of no more than 5 microns (for the most effective absorption by the lungs). When using a nebulizer, you must follow the device manufacturer's instructions.
The procedure for inhaling the drug should be performed in a sitting or standing position strictly upright, in a calm state, taking as deep breaths as possible through the mouthpiece of the nebulizer. You can use a nose clip to make breathing through your mouth easier.
After each use, the mouthpiece should be rinsed and disinfected following the manufacturer's instructions.
Patients receiving bronchodilators should inhale Colistat immediately after their use, as well as after physiotherapeutic procedures on the chest.
The solution for inhalation must be used immediately after preparation. The unused remainder of the solution must be disposed of.
Features of application
Concomitant use of intravenous colistimethate sodium with another antibacterial drug should be considered if possible, taking into account the sensitivity of the pathogen(s) to treatment. Since resistance to intravenous colistin has been reported, especially when used as monotherapy, concomitant use with another antibacterial agent should be considered to prevent the emergence of resistance.
Pregnant
Colistimethate sodium should only be used during pregnancy if the benefit outweighs the potential risk.
Children
Use for children from birth.
Drivers
Patients should be advised to avoid driving vehicles and other machinery.
Colistin
Stylab / Catalog / Antibacterial drugs / Colistin
STYLAB offers test systems for the determination of colistin in meat, fat, liver, as well as in fish, milk, eggs and animal feed using the ELISA method.
| Enzyme-linked immunosorbent assay (ELISA), strip plate | 5151COL Colistin ELISA |
Colistin, or polymyxin E, is a mixture of polymyxins E1 and E2, a narrow-spectrum antibiotic. Like other polymyxins, colistin is a cyclic polypeptide. It was first isolated in 1949 in Japan from a culture of the soil nitrogen-fixing bacterium Bacillus polymyxa.
Colistin and colistin sodium have been used in medicine since 1959. It is effective against gram-negative bacteria, including Pseudomonas aeruginosa , Klebsiella, Acinetobacter, Enterobacter. In the 1980s, the use of colistin was stopped due to severe side effects, including nephrotoxicity, ototoxicity and neurotoxicity. They are especially pronounced with intravenous administration of colistin. Colistin sodium is able to penetrate the placenta into the fetus, causing nephrotoxic and neurotoxic effects on the embryo.
A common side effect of inhaled colistin is bronchospasm. In addition, like other antibiotics, colistin inhibits microflora, which can lead to candidiasis or bacterial lesions of the oral cavity and gastrointestinal tract.
The use of colistin in medicine resumed in the 1990s due to the spread of bacteria resistant to other antibiotics. However, in 2015, data were published on the presence of the MCR-1 gene Escherichia coli , Klebsiella and Salmonella This gene is located in plasmids, which means resistance spreads quickly to other bacteria. This gene has been found in both pig intestinal bacteria and human microorganisms. Resistance to colistin is completely cross-resistance with other polymyxins. However, it does not mean that the microorganism is resistant to antibiotics of other groups.
Colistin is currently used to treat infections caused by bacteria resistant to other antibiotics. Colistin is used intravenously or in forms for external use: in the form of creams, ointments, ear rinsing solutions, etc. In addition, colistin is used for inhalation for antibacterial therapy for cystic fibrosis and respiratory diseases. In some countries, including the Russian Federation, colistin is allowed to be used in veterinary medicine. It is used to treat bacterial diarrhea, including salmonellosis in poultry, calves, pigs and rabbits. For these purposes, colistin is mixed into the feed.
Both in the Russian Federation and in the countries of the European Union the following maximum permissible levels of colistin in food products have been adopted: in meat, fish and fat - 0.15 mg/kg, in liver and kidneys - 0.2 mg/kg, in milk - 0 .05 mg/kg, in egg – 0.3 mg/kg. For screening colistin in food and animal feed, it is convenient to use ELISA test systems. They allow you to quickly process a large number of samples and obtain quantitative results.
Literature
- Colistin: instructions, application and formula. Radar website.
- Sachin Gupta, Deepak Govil, Prem N. Kakar, Om Prakash, Deep Arora, Shibani Das, Pradeep Govil, and Ashima Malhotra. Colistin and polymyxin B: A re-emergence Indian J Crit Care Med. 2009 Apr-Jun; 13(2): 49–53.
- Roger L Nation and Jian Li. Colistin in the 21st Century. Curr Opin Infect Dis. 2009 Dec; 22(6): 535–543.
- Yi-Yun Liu, Yang Wang, Timothy R Walsh, Ling-Xian Yi, Rong Zhang, James Spencer, Yohei Doi, Guobao Tian, Baolei Dong, Xianhui Huang, Lin-Feng Yu, Danxia Gu, Hongwei Ren, Xiaojie Chen, Luchao Lv, Dandan He, Hongwei Zhou, Zisen Liang, Jian-Hua Liu, Jianzhong Shen. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis 2016; 16: 161–68. Published Online November 18, 2015
- The European Agency for the Evaluation of Medical Products Veterinary Medicines and Inspections. Committee for Veterinary Medical Products. Colistin. Summary Report. (1)EMEA/MRL/016/95-FINAL
- The European Agency for the Evaluation of Medical Products Veterinary Medicines and Inspections. Committee for Veterinary Medical Products. Colistin. Summary Report. (2). EMEA/MRL/815/02-FINAL January 2002
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Note!
Description of the drug Colistin-Vista por. d/r-ra d/in./ing. 2 million IU fl. No. 10*** on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.
