Colistin Therapy in Infants and Children

Abstract

COLISTIN, a polypeptide antibiotic derived from Aerobacillus colistinus, was introduced by Koyama in Japan in the year 1950.² Gastrointestinal absorption is limited so that intramuscular injection is required for systemic effect and for this purpose sodium colistimethate (sodium colistin methanesulfonate) has been in use in the United States. This drug has been shown to produce serum levels in proportion to the administered dose³ which are in excess of those required for inhibition and for bactericidal effect upon many Gram-negative organisms in vitro.⁴ Most strains of Pseudomonas, Escherichia coli, paracolon, and Klebsiella organisms have been demonstrated to be sensitive by tube dilution studies.⁵ The toxicity of colistin in older children and adults, though variably reported, has been slight with no residual damage or death.⁶ The study reported herein was devised in an attempt to determine whether colistin methane sulfonate was an effective and safe agent in