Colistin aerosols are frequently administered to patients with cystic fibrosis. However, questions arise concerning the effect of both jet and ultrasonic nebulizers on the properties of the drug. The aim of this study was to characterize the anti-Pseudomonas aeruginosa (PA) activity of colistin after jet (Pari LL) and ultrasonic (DP100) nebulization. A bench study was performed by capturing the...

It is interesting to observe how advances in research, as well as unmet medical needs, change attitudes and decisions in clinical practice. The expansion of use of intravenous colistin for the treatment of patients with multidrug-resistant (MDR) gram-negative bacterial infections is certainly such an example. Even a few years ago there were many opponents to the use of colistin. The medication ...

In a recent article, Garonzik et al. (4) importantly advanced our knowledge of the pharmacokinetics (PK) of colistin methanesulfonate (CMS) and the active drug that it forms, colistin. In their elegant population PK study of critically ill patients, the authors demonstrated that creatinine clearance (CLCR) significantly affects the total body clearance of CMS and colistin (4). It is important t...

Purpose Colistin is a drug of last resort for treating multidrug-resistant Acinetobacter baumannii infections. Unfortunately, colistin-resistant A. baumannii (CoR-AB) has been reported. Here, we examined the in vitro effect of mono- and combined antimicrobials against CoR-AB strains and their resistance mechanism, and evaluated the clinical outcomes of CoR-AB-infected patients. Patients and m...

In a recent article, Garonzik et al. (4) importantly advanced our knowledge of the pharmacokinetics (PK) of colistin methanesulfonate (CMS) and the active drug that it forms, colistin. In their elegant population PK study of critically ill patients, the authors demonstrated that creatinine clearance (CLCR) significantly affects the total body clearance of CMS and colistin (4). It is important t...

The increasing incidence of infections caused by multidrug-resistant Pseudomonas aeruginosa is a worldwide health problem. Because no new antipseudomonal agents are expected to be available in the near future, we evaluated the safety and efficacy of colistin, an old drug with bactericidal activity against this organism. We collected clinical and demographic data on 95 cancer patients diagnosed ...

Here we describe the effect of colistin on the barrier function of the mammalian urinary bladder epithelium. Addition of colistin to the mucosal solution of the rabbit urinary bladder epithelium (urothelium) resulted in an increase in the transepithelial conductance. The magnitude of the increase in transepithelial conductance was dependent on the membrane voltage, concentration of colistin, an...

BACKGROUND Acute kidney injury (AKI) remains a treatment-limiting toxicity of colistin. Recently developed clinical practice guidelines from the Kidney Disease: Improving Global Outcomes (KDIGO) group have harmonized definitions of AKI, but have not been widely applied to patients receiving colistin. METHODS We retrospectively defined AKI by KDIGO definitions among adult patients receiving in...

Multidrug-resistant gram-negative bacteria are an important issue in intensive care units worldwide. Colistin, one of the earliest polymyxin antibiotics, was once widely used for the treatment of gram-negative bacterial infections. However, its use is now limited due to concerns over nephrotoxicity. The appearance of multidrug-resistant species, including A. baumannii and P. aeruginosa, has led...

While the MerR-like transcriptional regulator BrlR has been demonstrated to contribute to Pseudomonas aeruginosa biofilm tolerance to antimicrobial agents known as multidrug efflux pump substrates, the role of BrlR in resistance to cationic antimicrobial peptides (CAP), which is based on reduced outer membrane susceptibility, is not known. Here, we demonstrate that inactivation of brlR coincide...