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).
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).