Better guidelines for antibiotics curb the rise of superbugs

Doctors can now more confidently administer a drug that protects against bacterial superbugs thanks to the development of scientifically-based dosing guidelines for the antibiotic colistin.

Colistin treats serious infections in critically ill patients, including those with kidney failure who are receiving dialysis. Developed by an international team, the guidelines will allow for more effective use of the drug and reduce the likelihood of bacteria developing resistance to it.

The researchers said colistin was increasingly the last option available to treat seriously ill patients who have infections caused by an important class of antibiotic-resistant bacteria, known as Gram-negative ‘superbugs’.

“The rise of antibiotic-resistant bacteria, combined with very few new antibiotics in development, has meant colistin is often the only treatment that hospital physicians can use in critically ill patients who are most at risk from a superbug infection,” they said. “Unfortunately, colistin was developed more than 50 years ago when manufacturers were not required to provide accurate dosing guidelines. This has meant doctors are often shooting in the dark with respect to how much colistin should be administered to individual patients.”

Insufficient dosage could leave patients vulnerable to infection and enable bacteria to become resistant, which could lead to more powerful superbugs in the future.

The international research team was able to develop a dosing formula for colistin based on their results from 105 critically ill patients administered the antibiotic.

All of the patients were already receiving colistin for either a bloodstream infection or pneumonia due to multi-drug resistant bacteria. The patients were located at hospitals in Thailand or the USA.

The new guidelines will improve patient care, the study authors said.

Read more at Antimicrobial Agents and Chemotherapy