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Antimicrobial · FDA Approved

Colistin (Polymyxin E)

FDA-approved

How to ask your doctor
Written by Peptide Association Editorial TeamLast reviewed Editorial policy

01 · Overview

Colistin, also known as polymyxin E, is a cyclic polypeptide antibiotic structurally similar to polymyxin B. It disrupts the Gram-negative outer membrane by binding lipopolysaccharide, increasing permeability and causing cell death.

It is administered as colistimethate sodium, an inactive prodrug hydrolyzed in vivo to the active colistin base. FDA drug approval records list colistimethate sodium products; the original brand product is discontinued, while generic colistimethate sodium injections remain prescription products.

02 · Research summary & key findings

Colistin is used as a last-resort therapy for multidrug-resistant Gram-negative infections, and like polymyxin B it carries dose- and duration-related nephrotoxicity, with the older assumption that its renal risk is lower than that of polymyxin B now questioned (PMID 25266910). In 2015 the first plasmid-mediated polymyxin resistance mechanism, MCR-1, was reported in Enterobacteriaceae from food animals, raw meat and hospital inpatients in China; the plasmid transferred readily by conjugation and MCR-1 production negated colistin efficacy in a murine model (PMID 26603172). The authors warned that plasmid-mediated colistin resistance was likely to spread globally (PMID 26603172).

03 · Regulatory status

Colistin (Polymyxin E) has received FDA approval and is available for clinical use under appropriate medical supervision. Consult a qualified healthcare provider for prescribing information.

Colistin (Polymyxin E) is an FDA-approved medicine prescribed for the conditions on its label. It is not part of our intake, so we do not propose protocols for it. If you think it may be relevant to you, talk to your own doctor. How to ask your doctor.

04 · Administration routes

  • Intravenous
  • Intramuscular
  • Inhalation

References

  1. [1]Adverse reactions associated with systemic polymyxin therapy Pharmacotherapy, 2015. PMID 25266910
  2. [2]Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study Lancet Infect Dis, 2016. PMID 26603172

Primary literature

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Disclaimer: This information is provided for educational and research purposes only. It is not intended as medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting any peptide therapy. The Peptide Association does not endorse or recommend any specific treatment protocol. See our editorial policy for how this content is produced and reviewed. Clinicians: join the network.