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Colistin Dosing Cheat Sheet

Unit Conversions

9 MIU ≈ 300 mg CBA

WRITE ORDERS IN MIU or mg CBA

Conversion Calculator

🚀 Loading Dose (LD) – Adults

  • 9 MIU (≈ 300 mg CBA) IV over 30–60 min ×1.
  • Start Maintenance Dose 12–24 h after LD.

🧮 Maintenance Dose (Non‑Dialysis)

Divide total daily dose q12h (30–60 min infusion). Estimate CrCl via Cockcroft–Gault (AdjBW if obese).

Dose Calculator

🧮 Renal Replacement Therapy (RRT)

LD always: 9 MIU (300 mg CBA) → infuse each MD over 30–60 min.

MD Baseline (non‑dialysis days): 130 mg CBA/day (~3.95 MIU) q12h.

Intermittent Hemodialysis (IHD)

  • Dialysis days: add post‑HD supplement:
    • +40 mg CBA (~1.2 MIU) for 3‑h IHD.
    • +50 mg CBA (~1.6 MIU) for 4‑h IHD.
  • Prefer HD late in dosing interval.

Sustained Low‑Efficiency Dialysis (SLED)

  • +10% of baseline daily dose per hour of SLED.
  • Example: 10‑h SLED → 130 mg + (10×10%) ≈ 260 mg/day (~7.9 MIU) → give 130 mg q12h.

Continuous RRT (CRRT: CVVHD/CVVHF/CVVHDF)

  • 440 mg CBA/day (~13.3 MIU) → 220 mg q12h (~6.65 MIU).

🧷 Notes

  • Nephrotoxicity: check SCr & UOP daily; avoid aminoglycosides, vancomycin, amphotericin B, contrast, loops.
  • No hepatic adjustment.
  • Infuse 30–60 min. Avoid Y‑site with nephrotoxins; flush line.

📚 References

  • International Consensus Guidelines for Optimal Use of the Polymyxins (Pharmacotherapy, 2019).
  • Nation RL et al. Updated US & European CMS dosing (Clin Infect Dis, 2016).
  • Garonzik SM et al. PK & dosing suggestions (Antimicrob Agents Chemother, 2011).
  • IDSA Guidance on AMR Gram‑negative infections (CRE, DTR‑PA, CRAB).
  • Jacobs M et al. CMS/colistin PK in AKI on IHD (Antimicrob Agents Chemother, 2016).