Comparative Pharmacology
Head-to-head clinical analysis: COLISTIMETHATE SODIUM versus COLY MYCIN S.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COLISTIMETHATE SODIUM versus COLY MYCIN S.
COLISTIMETHATE SODIUM vs COLY-MYCIN S
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Colistimethate sodium is a prodrug that hydrolyzes to colistin, a polymyxin antibiotic. Colistin disrupts bacterial cell membrane integrity by binding to lipopolysaccharides and phospholipids, increasing permeability leading to cell death.
Colistin is a polymyxin antibiotic that binds to lipopolysaccharides in the outer membrane of Gram-negative bacteria, disrupting the membrane and causing cell death.
2.5-5 mg/kg/day IV divided every 8-12 hours, based on colistin base activity (CBA). The typical dose is 2.5-5 mg/kg/day of colistimethate sodium (CMS) administered intravenously in 2-3 divided doses. For critically ill patients, a loading dose of 5 mg/kg CBA (approximately 9 million IU) may be given, followed by maintenance doses adjusted for renal function.
2.5 mg/kg/dose IV every 12 hours for 7-14 days (based on colistin base activity).
None Documented
None Documented
In adults with normal renal function: 2-3 hours (terminal). Prolonged to 20-40 hours in moderate-severe renal impairment; >40 hours in anuria. Dose adjustment required for CrCl <50 mL/min.
Terminal elimination half-life: 2-4 hours in normal renal function; prolonged in renal impairment (up to 24-48 hours in anuria).
Primarily renal (tubular secretion and glomerular filtration); 60-70% of the dose is excreted unchanged in urine within 24 hours, with up to 80% recovered over 48 hours. Minor biliary/fecal elimination (<4%).
Renal: ~70-80% unchanged via glomerular filtration; biliary/fecal: ~15-20% as active drug and metabolites.
Category C
Category C
Polymyxin Antibiotic
Polymyxin Antibiotic