Colistimethate Sodium Dosing and Nephrotoxicity among in-Patients at Tertiary Care Hospital Karachi, Pakistan

Introduction: Colistimethate sodium (CMS) is a polymyxin group of antibiotics which were throw out for many years, due to their potential adverse reaction neurotoxicity and nephrotoxicity. The different guidelines reported regarding CMS dosing some based on Creatinine clearance (CrCl) weight CrCl. There are discrepancies in the prevalence nephrotoxicity that has been included various definitions acute renal injury doses used variety literature. In EMA guideline they suggested dose as 9 MIU equivalent 300 mg CBA given maintenance with normal function patients. FDA standard remains 5 mg/kg per day also dependent patient weight. aim this study was evaluate criteria colistimethate associated nephrotoxicity.
 Methodology: A prospective observational conducted private sector tertiary care hospital Karachi, Pakistan, duration six months from July 2020 December 2020. Sample size comprised 157 patients, calculated at 35% prevalence, 95% Confidence Interval 7% margin error. Patient ≥ 18 years age, who have received intravenous therapy greater than 48 hours. Patients having an kidney or dialysis (at start therapy) excluded. Loading daily by using actual body (CrCl). Cockcroft Gault equation estimate CrCl before after therapy. Nephrotoxicity assessed RIFLE criteria. SPSS-20 frequency distribution percentage calculation show categorical variable.
 Results: Among enrolled 101 (64.3%) male 56(35.7%) female (Table 1). Table 2. represents 68(43.3%) patients admitted intensive unit (ICU) 89(56.7%) medicinal ward; 22.9% between age range 60-70 3). all 63(40.1%) risk nephrotoxicity, 27(17.2%) developing 14(8.9%) diagnosed failure 53(33.8%) found not developed 4). exhibits 48.4% receiving while 51.6% 2.5-5 mgCBA/kg/day according FDA. high among regimen (44.5%).
 Conclusion: It concluded significant impact Close monitoring function, particularly first week should be considered toxicity CMS.