We thank Dr Mubareka and Dr Rubinstein for their thoughtful commentary [1] related to our recent publication on aerosolized colistin for the treatment of nosocomial pneumonia due to multidrug-resistant Gram-negative bacteria in patients without cystic fibrosis [2]. We would like to provide some additional clarifications related to the formulation of colistin used in our study because the commen...

Acinetobacter baumannii has emerged as an important opportunistic pathogen due to its ability to acquire resistance to most currently available antibiotics. Colistin is often considered as the last line of therapy for infections caused by multidrug-resistant A. baumannii (MDRAB). However, colistin-resistant A. baumannii strain has recently been reported. To explore how multiple drug-resistant A...

BACKGROUND Inhaled antibiotics are commonly used in the treatment of cystic fibrosis lung disease. A previous study suggested neutrophil elastase activation by colistin in vitro. Here, we investigated direct effects of the commonly used antibiotics colistin and tobramycin on neutrophil elastase activity. METHODS Neutrophil elastase was measured spectrophotometrically. The antibiotics colistin...

The management challenges of patients with nosocomial pneumonia are great because of resistance among the responsible pathogens. In this issue of Critical Care, Argyris Michalopoulos and colleagues describe the use of inhaled colistin in the treatment of multidrug-resistant Gram-negative nosocomial pneumonia in a small group of patients. Although seven of eight patients who received nebulized c...

KOIKE e t al. reported that a cationic acylpeptide antibiotic, colistin (polymyxin E) caused the formation of blebs on the outer layer of the Gram-negative bacterial cell envelope". They have also reported that colistin affects the cytoplasmic membrane, leads to leakage of cytoplasmic 260 nm-absorbing materials and has specific bursting-activity on spheroplasts of Gram-negative bacteria'). On t...

Colistin, also known as polymyxin E, a polymyxin antibiotic, comprised of colistin E1 and colistin E2, has good inhibitory effect for pathogen infection [1,2]. The characteristic lariat structure of colistin E1 was proven necessary for antimicrobial activity [3]. Since the sulfate polymyxin compounds were separated from different types of bacillus polymyxa in 1947, they have been tested by vitr...

Data regarding the role of inhaled colistin in critically ill pediatric patients without cystic fibrosis are scarce. Three children (one female), admitted to the intensive care unit (ICU) of a tertiary-care pediatric hospital in Athens, Greece, during 2004-2009 received inhaled colistin as monotherapy for tracheobronchitis (two children), and as adjunctive therapy for necrotizing pneumonia (one...

BACKGROUND Colistin-resistant/carbapenem-resistant Acinetobacter baumannii is a significant challenge for antibiotic treatment and infection control policies. Since 2012, in Central Greece an increase of colistin/pan- resistant A. baumannii has occurred, indicating the need for further analysis. METHODS A total of 86 colistin-resistant/carbapenem-resistant out of 1228 A. baumannii clinical is...

www.chestpubs.org authors) showed that after IV administration of colistin methanesulfonate (CMS), the plasma concentration of colistin is apparently suboptimal. The adverb “apparently” is necessary because the values of the pharmacodynamic indices that best predict the effi cacy of (free) colistin have been determined in in vitro and animal studies, 2 , 3 but are not yet known for humans. The ...

Colistin (Polymyxin E) is one of the few cationic antimicrobial peptides commercialized in both human and veterinary medicine. For several years now, colistin has been considered the last line of defense against infections caused by multidrug-resistant Gram-negative such as Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Colistin has been extensively used orally sinc...