colistimethate

Adult Dosing .

Dosage forms:  INJ: 75 mg per mL

Special Note

[dosing clarification]

Info: dosing based on colistin base activity

infections, severe bacterial

[300 mg IV x1, then 300-360 mg/day IV divided q12h]

Info: for infections due to multi-drug resistant gram-negative bacteria incl. P. aeruginosa and A. baumannii

pneumonia, hospital-acquired or ventilator-assoc. (off-label)

[5 mg/kg/dose IV x1, then 2.5 mg x (1.5 x CrCl + 30) IV q12h x7 days]

Max: 340 mg/day; Info: may extend duration based on clinical response; refer to IDSA guidelines; use ABW and normalize to BSA to calculate CrCl

ventilator-associated pneumonia, adjunct tx (off-label)

[80-160 mg NEB q12h x7 days]

Info: may extend duration based on clinical response; refer to IDSA guidelines

resp. infections, cystic fibrosis pts (off-label)

[75 mg NEB q12h]

Info: doses used vary widely, range 30-150 mg NEB q12-24h

meningitis, bacterial (off-label)

[4.1 mg intrathecally q24h]

Info: for infections due to multi-drug resistant gram-negative bacteria; give w/ IV polymyxin B or IV colistimethate

ventriculitis, bacterial (off-label)

[4.1 mg intracerebroventricularly q24h]

Info: for infections due to multi-drug resistant gram-negative bacteria; give w/ IV polymyxin B or IV colistimethate

renal dosing

[IV route]

CrCl 80-89: 340 mg/day IV divided q12h; CrCl 70-79: 300 mg/day IV divided q12h; CrCl 60-69: 275 mg/day IV divided q12h; CrCl 50-59: 245 mg/day IV divided q12h; CrCl 40-49: 220 mg/day IV divided q12h; CrCl 30-39: 195 mg/day IV divided q12h; CrCl 20-29: 175 mg/day IV divided q12h; CrCl 10-19: 160 mg/day IV divided q12h; CrCl 5-9: 145 mg/day IV divided q12h; CrCl <5: 130 mg/day IV divided q12h; Info: use ABW and normalize to BSA to calculate CrCl

HD: give 130 mg IV qd, on dialysis days admin. after dialysis; give 40-50 mg IV x1 as supplement after dialysis; PD: not defined

[NEB, intrathecal, or intracerebroventricular route]

renal impairment: not defined

HD/PD: not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  INJ: 75 mg per mL

Special Note

[dosing clarification]

Info: dosing based on colistin base activity

infections, severe bacterial

[2.5-5 mg/kg/day IM/IV divided q6-12h]

Info: for infections due to multi-drug resistant gram-negative bacteria incl. P. aeruginosa and A. baumannii

resp. infections, cystic fibrosis pts (off-label)

[75 mg NEB q12h]

Info: doses used vary widely, range 30-150 mg NEB q12-24h

renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: consider adult renal dosing for guidance

hepatic dosing

[not defined]