{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:40:10Z","timestamp":1761129610563,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Molecules"],"abstract":"<jats:p>Colistin is administered as its inactive prodrug colistimethate (CMS). Selection of an individualized CMS dose for each patient is difficult due to its narrow therapeutic window, especially in patients with chronic kidney disease (CKD). Our aim was to analyze CMS use in patients with CKD. Secondary objectives were to assess the safety and efficacy of CMS in this special population. In this prospective observational cohort study of CMS-treated CKD patients, CKD was defined as the presence of a glomerular filtration rate (GFR) &lt; 60 mL\/min\/m2 for more than 3 months. The administered doses of CMS were compared with those recently published in the literature. Worsened CKD at the end of treatment (EOT) was evaluated with the RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) criteria. Colistin plasma concentrations (Css) were measured using high-performance liquid chromatography. Fifty-nine patients were included. Thirty-six (61.2%) were male. The median age was 76 (45\u201395) years and baseline GFR was 36.6 \u00b1 13.6. The daily mean CMS dosage used was compared with recently recommended doses (3.36 vs. 6.07; p &lt; 0.001). Mean Css was 0.9 (0.2\u20132.9) mg\/L, and Css was &lt;2 mg\/L in 50 patients (83.3%). Clinical cure was achieved in 43 (72.9%) patients. Worsened renal function at EOT was present in 20 (33.9%) patients and was reversible in 10 (52.6%). The CMS dosages used in this cohort were almost half those currently recommended. The mean achieved Css were under the recommended target of 2 mg\/dL. Despite this, clinical cure rate was high. In this patient cohort, the incidence of nephrotoxicity was similar to those found in other recent studies performed in the general population and was reversible in 52.6%. These results suggest that CMS is safe and effective in patients with CKD and may encourage physicians to adjust dosage regimens to recent recommendations in order to optimize CMS treatments.<\/jats:p>","DOI":"10.3390\/molecules24030530","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T11:19:58Z","timestamp":1549019998000},"page":"530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Colistin Use in Patients with Chronic Kidney Disease: Are We Underdosing Patients?"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9562-514X","authenticated-orcid":false,"given":"Luisa","family":"Sorli","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"},{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Luque","sequence":"additional","affiliation":[{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"},{"name":"Pharmacy Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Li","sequence":"additional","affiliation":[{"name":"Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University, Clayton, 3800 Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital del Mar, Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB). CEXS-Universitat Pompeu Fabra, 08003, 08003 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuria","family":"Campillo","sequence":"additional","affiliation":[{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"},{"name":"Pharmacy Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xenia","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"},{"name":"Pharmacy Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jade","family":"Soldado","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"},{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"Domingo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"},{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milagro","family":"Montero","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"},{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8428-1836","authenticated-orcid":false,"given":"Santiago","family":"Grau","sequence":"additional","affiliation":[{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"},{"name":"Pharmacy Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9873-5459","authenticated-orcid":false,"given":"Juan P.","family":"Horcajada","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital del Mar, Infectious Pathology and Antimicrobial Research Group (IPAR), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), Universitat Aut\u00f2noma de Barcelona (UAB), CEXS-Universitat Pompeu Fabra, 08003 Barcelona, Spain"},{"name":"Spanish Network for Research in Infectious Diseases (REIPI RD 16\/0016\/0015), Instituto de Salud Carlos III, 28001 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ijantimicag.2004.10.001","article-title":"Evaluation of colistin as an agent against multi-resistant Gram-negative bacteria","volume":"25","author":"Li","year":"2005","journal-title":"Int. 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Antimicrob. Chemother."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1128\/AAC.01741-13","article-title":"Pharmacokinetics of colistin methanesulfonate and formed colistin in end-Stage renal disease patients receiving continuous ambulatory peritoneal dialysis","volume":"58","author":"Koomanachai","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1093\/jac\/dki461","article-title":"Pharmacokinetics of inhaled colistin in patients with cystic fibrosis","volume":"57","author":"Ratjen","year":"2006","journal-title":"J. Antimicrob. Chemother."},{"doi-asserted-by":"crossref","unstructured":"Sorl\u00ed, L., Luque, S., Segura, C., Campillo, N., Montero, M., Esteve, E., Herrera, S., Benito, N., Alvarez-Lerma, F., and Grau, S. (2017). Impact of colistin plasma levels on the clinical outcome of patients with infections caused by extremely drug-resistant Pseudomonas aeruginosa. 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Agents"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3430","DOI":"10.1128\/AAC.01361-08","article-title":"Population pharmacokinetic analysis of colistin methanesulfonate and colistin after intravenous administration in critically ill patients with infections caused by gram-negative bacteria","volume":"53","author":"Plachouras","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1093\/cid\/civ964","article-title":"Updated US and European Dose Recommendations for Intravenous Colistin: How Do They Perform?","volume":"62","author":"Nation","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"ciw839","DOI":"10.1093\/cid\/ciw839","article-title":"Dosing guidance for intravenous colistin in critically-ill patients","volume":"64","author":"Nation","year":"2016","journal-title":"Clin. Infect. 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Appl."}],"container-title":["Molecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1420-3049\/24\/3\/530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:30:10Z","timestamp":1760185810000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1420-3049\/24\/3\/530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,1]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,2]]}},"alternative-id":["molecules24030530"],"URL":"https:\/\/doi.org\/10.3390\/molecules24030530","relation":{},"ISSN":["1420-3049"],"issn-type":[{"type":"electronic","value":"1420-3049"}],"subject":[],"published":{"date-parts":[[2019,2,1]]}}}