Guideline

COLISTIN: adult and paediatric guideline for South Africa, 2016

Quinten Labuschagne, Natalie Schellack, Andries Gous, Elmien Bronkhorst, Gustav Schellack, Lindie van Tonder, Archele Truter, Caroline Smith, Ruth Lancaster, Sonya Kolman
Southern African Journal of Infectious Diseases | Vol 31, No 1 | a95 | | © 2019 Quinten Labuschagne, Natalie Schellack, Andries Gous, Elmien Bronkhorst, Gustav Schellack, Lindie van Tonder, Archele Truter, Caroline Smith, Ruth Lancaster, Sonya Kolman | This work is licensed under CC Attribution 4.0
Submitted: 15 May 2019 | Published: 31 March 2016

About the author(s)

Quinten Labuschagne, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Natalie Schellack, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Andries Gous, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Elmien Bronkhorst, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Gustav Schellack, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Lindie van Tonder, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Archele Truter, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Caroline Smith, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Ruth Lancaster, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa
Sonya Kolman, South African Society of Clinical Pharmacy (SASOCP), Pretoria, South Africa

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Abstract

This document was created to serve as a guideline for colistin prescribing in South Africa. Antimicrobial resistance is threatening the effective prevention and treatment of a wide variety of infections, especially those that are caused by multi-drug-resistant (MDR) gram-negative bacteria. Colistin is typically used as salvage therapy, or last-line treatment, for MDR gram-negative infections. The dosing regimen should be optimised to be therapeutic and halt the emergence of resistance, whilst minimizing toxicity. This document provides evidence-based recommendations for adult and paediatric dosing, dosing in renal impairment, and the use of combination therapy to increase synergistic effects, as well as guidelines on the reconstitution and administration of colistin. This guideline is specifically aimed at healthcare workers who routinely treat patients with MDR gram-negative infections, especially in the intensive care setting.

Keywords

Colistimethate sodium; CMS; polymyxin E; colistin guideline; multi-drug-resistant gram-negative bacteria

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