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Table 1 Pharmacokinetics of colistin (CMS)

From: Colistin: recent data on pharmacodynamics properties and clinical efficacy in critically ill patients

Metabolism: CMS is a prodrug that is hydrolyzed after i.v. administration to produce derivatives, including the active drug colistin
It is not absorbed from the gastrointestinal tract
Distribution of CMS to lung parenchyma, pleural cavity, pericardial fluids, and CSF is poor
Time to peak: 10 min following i.v. administration
Half-life elimination: 2-3 h (CMS i.v. administration, with normal renal function). In patients with anuria = 2-3 days.
For colistin (base): 250 min
CMS is tightly bound to membrane lipids of cells in many body tissues, including liver, lungs, kidneys, brain, heart, and muscles
CMS is excreted primarily in the urine (as unchanged drug). No biliary excretion has been reported in humans
Data on the pharmacokinetics of i.v. CMS in critically ill patients are limited