@article{3061759,
    title = "Pharmacokinetic evaluation of colistin sodium",
    author = "Michalopoulos, A.S. and Karatza, D.C. and Gregorakos, L.",
    journal = "Expert Opinion on Drug Metabolism and Toxicology",
    year = "2011",
    volume = "7",
    number = "2",
    pages = "245-255",
    doi = "10.1517/17425255.2011.541439",
    keywords = "cilastatin plus imipenem;  colistimethate;  colistin;  gentamicin;  polymyxin B;  rifampicin;  sulbactam, Acinetobacter baumannii;  Acinetobacter infection;  antibiotic resistance;  antibiotic therapy;  area under the curve;  bacteremia;  bacterial meningitis;  bacterial pneumonia;  bactericidal activity;  capillary electrophoresis;  central nervous system infection;  combination chemotherapy;  cystic fibrosis;  drug absorption;  drug blood level;  drug clearance;  drug degradation;  drug determination;  drug distribution;  drug dosage form comparison;  drug efficacy;  drug half life;  drug protein binding;  drug safety;  drug structure;  drug tissue level;  drug urine level;  high performance liquid chromatography;  hospital infection;  human;  immunomodulation;  Klebsiella pneumoniae;  Klebsiella pneumoniae infection;  maximum plasma concentration;  minimum inhibitory concentration;  monotherapy;  nonhuman;  Pseudomonas aeruginosa;  Pseudomonas infection;  recommended drug dose;  respiratory tract infection;  review;  sepsis;  single drug dose;  thin layer chromatography;  urinary tract infection;  ventilator associated pneumonia, Animals;  Anti-Bacterial Agents;  Area Under Curve;  Clinical Trials as Topic;  Colistin;  Critical Illness;  Cross Infection;  Drug Evaluation, Preclinical;  Drug Resistance, Multiple, Bacterial;  Gram-Negative Bacteria;  Gram-Negative Bacterial Infections;  Humans;  Microbial Sensitivity Tests, Acinetobacter baumannii;  Animalia;  Klebsiella pneumoniae;  Negibacteria;  Pseudomonas aeruginosa",
    abstract = "Importance of the field: Although colistin has recently played a key role in the treatment of nosocomial infections due to multidrug resistant Gram-negative pathogens, there is a lack of clinical studies examining colistin pharmacokinetics (PKs) in humans. This refers to all routes of colistin administration in clinical practice. Colistin PK data are also limited in critically ill patients. Areas covered in this review: Literature search took into account data dealing with colistin PK obtained from animal studies performed during previous decades (1970s, 1980s and 1990s) and from recent human studies performed during the last decade. What the reader will gain: Valuable information on pharmacodynamics (PD)/PK of colistin used in the treatments of nosocomial infections due to multidrug resistant Gram-negative pathogens, mostly Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae. A better understanding of PKs could offer significant improvement of colistin use in humans, especially optimization of colistin doses in different routes of administration in order to maximize clinical efficacy and minimize adverse effects and rate of resistance. Take home message: There is a lack of human studies on colistin PK and PD. Significant PD parameters best predicting colistin efficacy and their optimal values such as Cmax:MIC ratio, AUC/MIC and T > MIC have not yet been clearly defined. It should be noted that further investigation on colistin PK/PD in vitro and in vivo models is required. © 2011 Informa UK, Ltd."
}