International Consensus Guidelines for the Optimal Use of the Polymyxins: Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti‐infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP)
Top Cited Papers
Open Access
- 1 January 2019
- journal article
- research article
- Published by Wiley in Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
- Vol. 39 (1), 10-39
- https://doi.org/10.1002/phar.2209
Abstract
The polymyxin antibiotics colistin (polymyxin E) and polymyxin B became available in the 1950s and thus did not undergo contemporary drug development procedures. Their clinical use has recently resurged, assuming an important role as salvage therapy for otherwise untreatable gram‐negative infections. Since their reintroduction into the clinic, significant confusion remains due to the existence of several different conventions used to describe doses of the polymyxins, differences in their formulations, outdated product information, and uncertainties about susceptibility testing that has led to lack of clarity on how to optimally utilize and dose colistin and polymyxin B. We report consensus therapeutic guidelines for agent selection and dosing of the polymyxin antibiotics for optimal use in adult patients, as endorsed by the American College of Clinical Pharmacy (ACCP), Infectious Diseases Society of America (IDSA), International Society of Anti‐Infective Pharmacology (ISAP), Society for Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP). The European Society for Clinical Microbiology and Infectious Diseases (ESCMID) endorses this document as a consensus statement. The overall conclusions in the document are endorsed by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). We established a diverse international expert panel to make therapeutic recommendations regarding the pharmacokinetic and pharmacodynamic properties of the drugs and pharmacokinetic targets, polymyxin agent selection, dosing, dosage adjustment and monitoring of colistin and polymyxin B, use of polymyxin‐based combination therapy, intrathecal therapy, inhalation therapy, toxicity, and prevention of renal failure. The treatment guidelines provide the first ever consensus recommendations for colistin and polymyxin B therapy that are intended to guide optimal clinical use.Keywords
Funding Information
- American College of Clinical Pharmacy
This publication has 159 references indexed in Scilit:
- Pharmacokinetics of Colistin in Cerebrospinal Fluid after Intraventricular Administration of Colistin MethanesulfonateAntimicrobial Agents and Chemotherapy, 2012
- Predictors of Mortality in Bloodstream Infections Caused by Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae: Importance of Combination TherapyClinical Infectious Diseases, 2012
- Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatmentClinical Microbiology & Infection, 2011
- Ascorbic acid protects against the nephrotoxicity and apoptosis caused by colistin and affects its pharmacokineticsJournal of Antimicrobial Chemotherapy, 2011
- Incidence of and Risk Factors for Colistin-Associated Nephrotoxicity in a Large Academic Health SystemClinical Infectious Diseases, 2011
- Pharmacokinetics of Polymyxin B in a Patient With Renal Insufficiency: A Case ReportClinical Infectious Diseases, 2011
- Risk factors for colistin-associated nephrotoxicityJournal of Infection, 2011
- Colistin therapy for microbiologically documented multidrug-resistant Gram-negative bacterial infections: a retrospective cohort study of 258 patientsInternational Journal of Antimicrobial Agents, 2010
- Management of meningitis due to antibiotic-resistant Acinetobacter speciesThe Lancet Infectious Diseases, 2009
- Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock*Critical Care Medicine, 2006