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Colistin emerged in the last decade as a savior for the treatment of critically septic patients who suffer MDR-GNB infections.This development came in time with the drying new antibacterial pipelines. MDR- GNB became problematic in ICU’s including MDR Acinetobacter spp., Pseudomonas aeruginosa, and carbapenemase producing Enterobacteriaecae (CPE). With the resurgence of wide colistin prescription especially in ICU’s, awareness on when to switch to this reintroduced drug is required.
Recently, it is observed that there are differences between the past dosages and the currently proposed dosages. Nephrotoxicity and neurotoxicity are observed to be less than what was published in the past. This may be due to more pure preparations and attention to other drug therapies that are employed in the critically ill patients residing the ICU’s. However,randomized control studies are still lacking to shed light on its efficacy and safety. Agreement is still looming on dosages, and monotherapy of colistin versus its combination with other agents.
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