Bestomycin
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polymyxin B and lolistin : They are active against most gram negative bacteria, notably. Pseudomonas, exceptions are proteus, Serratia and Neisseria. Both have very similar range of activity, but colistin is more potent on pseudomonas, Salmonella and shigella. Little or no absorption occurs form oral route or even form denuded skin (burn, ulcers).
Indications: Systemic urinary tract. meningeal local and enteric infections caused by gram negative organisms.
Dosage: Polymyxin B, 15,000-25,000 u/kg body wt daily for 7-10 days. Max 2,000,000 i.u. per day colistin suphate : 25-100 mg 3 times orally daily children and infants. 5-15 mg/kg body wt in 3 divided doses.
Contraindication: Hypersensitivity.
Special Precaution: Perforated tympanic membrane, monitor renal functions.
Pediatric: Use with caution
Pregnancy: Contraindicated.
Lactation: Contraindicated.
Elderly: Use with caution.
Side-effects: Intra miscular injection causes pain flushing and presthesias after injection. Nephrotoxicity, neruological disturbaces, ototoxicity.
Drug Interaction: Potentiates nephrotoxicity produced by cephalothin and aminoglycosides. Neuromuscular blockade potentaiated by ether anasthesia, sedatives, muscle. Synergy with trimethroprim and useful combination with fifampicin
COLISTIN
Drug Interactions: Potentiates action of curafi form muscle relaxants. nephrotoxicity of aminoglycosides. Potenitales chloramphenicaol erythromycin and trimethoprim