A COMPREHENSIVE REVIEW PAPER OF COLISTIN

Abstract

Colistin, a decades-old polymyxin antibiotic that was originally discontinued due to its neurotoxicity and nephrotoxicity, has seen a resurgence in clinical use due to the global rise of multidrug-resistant (MDR) Gram-negative bacteria. Colistin, also known as polymyxin E, mainly causes cell death by interacting with lipopolysaccharides to rupture the outer membrane of Gram-negative bacteria. It is an essential last-resort medication because to its distinct mode of action and wide-ranging efficacy against Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae.
But as colistin has become more popular, worries about toxicity, dosage issues, and the concerning rise in colistin resistance—particularly plasmid-mediated mcr genes that promote horizontal gene transfer between bacterial species—have grown. The chemistry, mechanism of action, pharmacokinetics, clinical uses, toxicity profile, and molecular basis of resistance of colistin are all well covered in this paper.  To counter the growing threat of pan-resistant bacterial infections, the prudent use of colistin, worldwide antimicrobial stewardship, and ongoing research into resistance mechanisms are still crucial.