Pharmacokinetics of Colistin Following a Single Dose of Intravenous Colistimethate Sodium in Critically Ill Neonates

Narongsak Nakwan, Siripa Usaha, Kulkanya Chokephaibulkit, Paola Villani, Mario Regazzi, Roberto Imberti

Research output: Contribution to journalArticle

Abstract

In this study we sought to evaluate the pharmacokinetics of colistin following intravenous (iv) administration of colistimethate sodium (CMS) in the critically ill neonates with Gram-negative bacterial infections. A single iv dose of CMS (approximately 150,000 IU/kg, equivalent to 5 mg/kg colistin base activity (CBA) was administered to 7 critically ill neonates. Mean (±SD) maximum plasma colistin concentration (Cmax) and area under the time-concentration curve from 0 to infinity (AUC0-∞) were 3.0 ± 0.7 µg/mL and 25.3 ± 10.4 µg.h/mL, respectively. Time to maximum concentration (Tmax), half-life (t1/2), apparent volume of distribution and clearance were 1.3 ± 0.9 h, 9.0 ± 6.5 h, 7.7 ± 9.3 L/kg, and 0.6 ± 0.3 L/h/kg, respectively.Following a dose regimen of 5 mg/kg CBA every 24 hours, the average concentration expected at steady-state (Cave,ss) is 1.1 ± 0.4 µg/mL. In critically ill neonates a single iv dose of 5 mg CBA/kg (approximately 150,000 IU/Kg of CMS) resulted in suboptimal plasma concentrations of colistin. According to our pharmacokinetics data, the dosage of CMS currently used in critically ill neonates is insufficient.

Original languageEnglish
JournalPediatric Infectious Disease Journal
DOIs
Publication statusAccepted/In press - Jun 7 2016

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)

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