Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Renal and neurological side effects of colistin in critically ill patients | Spapen et al. Annals of Intensive Care 2011 1 14 http content 1 1 14 Ù Annals of Intensive Care a SpringerOpen Journal REVIEW Open Access Renal and neurological side effects of colistin in critically ill patients Herbert Spapen Rita Jacobs Viola Van Gorp Joris Troubleyn and Patrick M Honoré Abstract Colistin is a complex polypeptide antibiotic composed mainly of colistin A and B. It was abandoned from clinical use in the 1970s because of significant renal and to a lesser extent neurological toxicity. Actually colistin is increasingly put forward as salvage or even first-line treatment for severe multidrug-resistant Gram-negative bacterial infections particularly in the intensive care setting. We reviewed the most recent literature on colistin treatment focusing on efficacy and toxicity issues. The method used for literature search was based on a PubMed retrieval using very precise criteria. Despite large variations in dose and duration colistin treatment produces relatively high clinical cure rates. Colistin is potentially nephrotoxic but currently used criteria tend to overestimate the incidence of kidney injury. Nephrotoxicity independently predicts fewer cures of infection and increased mortality. Total cumulative colistin dose is associated with kidney damage suggesting that shortening of treatment duration could decrease the incidence of nephrotoxicity. Factors that may enhance colistin nephrotoxicity . shock hypoalbuminemia concomitant use of potentially nephrotoxic drugs must be combated or controlled. Neurotoxicity does not seem to be a major issue during colistin treatment. A better knowledge of colistin pharmacokinetics in critically ill patients is imperative for obtaining colistin dosing regimens that ensure maximal antibacterial activity at minimal toxicity. Introduction Colistin belongs to the polymyxin class of cationic polypeptide antibiotics. It is administered as the prodrug colistimethate sodium CMS a fraction of
