Revision of Colistin IV from Aug 13, 2020

Dosing: Adult Antimicrobial Dosing, Non-dialysis

Indication Dosing
All IV Indications 5 mg/kg IV x1 loading dose, then contact ID pharmacy for maintenance dose recommendations

ZSFG: Non-formulary

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication

Intermittent Hemodialysis

Continuous Hemodialysis
All IV Indications 5 mg/kg IV x1 loading dose, then contact ID pharmacy for dosing recommendations

Dialysis Notes

Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.  For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.

Dosing for inhaled colistin per primary team protocols

Other more effective, less-toxic agents are available for most serious Gram-negative rod infections.  In cases where an IV polymyxin is necessary, polymyxin B should be used preferentially for non-urinary tract infections in adults.

Restricted to ID or Antimicrobial Stewardship

*Inhaled use of colistin is allowed for unrestricted use in prophylaxis in lung transplant.

References: