Colistimethate Sodium
Colistimethate Sodium is an antibiotic derived from bacteria of the genus Paenibacillus. It is the last-
resort treatment for multidrug-resistant Gram-negative infections including pneumonia which
includes infections caused by Pseudomonas aeruginosa, Klebsiella pneumoniae, or Acinetobacter.
Colistimethate Sodium is supplied in forms for injection into a vein or into a muscle, or inhaled,
known as Colistimethate sodium and can also be applied to the skin or taken by mouth, known as
colistin sulfate.
Colistimethate Sodium is sold under the brand names Xylistin, Coly-Mycin M, Colobreathe among
others.
Koyama discovered polymyxins, initially in 1947, and Colistimethate Sodium as a secondary
metabolite of the Gram-positive soil. It was approved for medical use in the United States in 1970.
Due to its safety record and worldwide use, it features on the World Health Organization's List of
Essential Medicines in addition to classifying Colistimethate Sodium as critically important for human
medicine. Since the expiry of its initial patent protection, it is now made by several companies
around the world as a generic medication.
Dosage Forms & Administration
Colistimethate Sodium is sold as a powder for injection in 150mg per vial. In the treatment of
Susceptible Infections, the initial adult dose prescribed is 2.5-5 mg per kilo per day, spaced 6 to 12
hours apart. The daily maximum dose can not exceed 5 mg. this is followed by a Maintenance dose
of 9MIU a day, administered in 2-3 divided doses and for critically ill patients, an initial loading dose
of 9 MIU is prescribed.
The price of Colistimethate Sodium
In India, the consumers have to pay a retail price of USD 600 for a supply of 60 vials of generic brand
of 1 MIU Colistimethate Sodium injection. This price is significantly higher in the developed world. In
the USA, a generic brand supply of 60 vials of 150mg costs the consumer an average retail price of
$2,883.38.
How does Colistimethate Sodium?
Colistimethate is an anti-biotic and also acts as a surface-active agent. It penetrates into and disrupts
the bacterial cell membrane. Colistimethate has both hydrophobic and lipophilic moieties as a
polycationic. It interacts and changes the permeability of the bacterial cytoplasmic membrane
leading to the deal of bacteria cells.
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