CAV\/VVHD      :Not dialysed. 2 million units every 48 hours1 IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugsAntibacterials: increased risk of nephrotoxicity with aminoglycosides and capreomycin; increased risk of nephrotoxicity and ototoxicity with teicoplanin and vancomycinCiclosporin: increased risk of nephrotoxicityCytotoxics: increased risk of nephrotoxicity and possibly ototoxicity with platinum agentsDiuretics: increased risk of ototoxicity with loop diureticsMuscle relaxants: polymyxins enhance the effect of non-depolarising muscle relaxants and suxamethoniumParasympathomimetics: polymyxins antagonise the effect of neostigmine and pyridostigmine ADMINISTRATION <\/H3> Reconstition<\/H4>Sodium chloride 0.9% or water for injection Route <\/H4>Oral, IV, Nebulised, Topical Rate of Administration <\/H4>Infusion: over 30 minutes Bolus: over 5 minutes (only if patient has a totally implantable venous access device, TIVAD)Comments<\/H4>IV: Give in 10\u201350 mL sodium chloride 0.9% or water for injectionInhalation: Dissolve in 2\u20134 mL sodium chloride 0.9% or water for injection OTHER INFORMATION <\/H4>Less than 0.5 mmol\/L sodium per 0.5\u20132 million unit vial (before reconstitution)Pharmacokinetic data: Lee CS, Marbury TC. Drug therapy in patients undergoing haemodialysis: clinical pharmacokinetic considerations. Clin Pharmacokinet. 1984; 9: 42\u201366.Can cause renal failure, muscle weakness and apnoea in overdose. Risk factors are usually the IV route, high doses, concomitant use with other nephrotoxic agents, and if the dose is not reduced appropriately in renal failureNo systemic absorption from oral administration in adults.188 CoLisTinIn renal impairment, neonates, and cystic fibrosis patients, plasma concentrations of 10\u201315 mg\/L (125\u2013200 units\/mL) are usually adequateDosage schedules in renal impairment vary according to which preparation is being used. Doses in the following table are from Dollery (1999) and Colomycin SPCPromixin SPC (IV): GFR: 40\u201375 mL\/min: 1\u20131.5 MIU twice daily25\u201340 mL\/: 0.8\u20132 MIU once or twice daily<25 mL\/min: 1\u20131.5 MIU every 36 hoursPromixin SPC (nebulised): GFR: 40\u201375 mL\/min: 1\u20131.5 MIU twice daily25\u201340 mL\/min: 1 MIU once or twice daily<25 mL\/min: 1\u20131.5 MIU every 36 hoursreferences:1. Trotman RL, Williamson JC, Shoemaker DM, et al. Antibiotic dosing in critically ill adult patients receiving continuous renal replacement therapy.
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