“The True Savior in Life-Threatening Bacterial Infections”.

Colistim contains colistimethate sodium, a narrow-spectrum polymyxin antibiotic effective mainly against Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. It is a last-resort antibiotic.

Indications:

Serious Gram-negative infections (cystic fibrosis, post-surgical meningitis, UTIs, SSTI, sepsis, IAIs, VAP) when other antibiotics have failed or are unsuitable. For adults and children.

Pharmaceutical Form:

Sterile white to off-white lyophilized powder in colorless glass vials with flip-off caps, available in four strengths: 1 MIU, 2 MIU, 3 MIU, 4.5 MIU

Reconstitution:

Strengths	Typical Diluent Volume
1 MIU	2-5 ml
2 MIU	5-10 ml
3 MIU	6-10 ml
4.5 MIU	8-10 ml

• Bolus: ≤10 mL diluent
• Infusion: further dilute in 50–100 mL NS, infuse over 30–60 min
• Nebulizer: 2–4 mL diluent

Dosage:

IV / Injection

• Adults/adolescents: Maintenance 9 MIU/day in 2–3 doses. Critically ill: loading dose 9 MIU (up to 12 MIU in selected cases).
• Children ≤40 kg: 75,000–150,000 IU/kg/day in 3 doses.
• 40 kg: adult dosing. Adjust for renal impairment.
  
Renal impairment:

Dose reduction is mandatory. Twice-daily dosing is preferred. Approximate guidance (adjust according to local guidelines and monitoring):

• CrCl <50–30 mL/min: 5.5–7.5 MIU/day
• CrCl <30–10 mL/min: 4.5–5.5 MIU/day
• CrCl <10 mL/min: ≈3.5 MIU/day
Nebulizer:
• < 2 years: 0.5–1 MIU twice daily
• Older children & adults: 1–2 MIU twice daily (max 2 MIU three times daily)