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Colistin: Balancing bactericidal doses and nephrotoxicity


An agent largely abandoned in the 1960s because of dose-dependent nephrotoxicity, colistin has made a recent resurgence based on its efficacy in treating carbapenem-resistant gram-negative bacteria. A recent article examines the relatively high doses used in the U.S, finds that nephrotoxicity begins to develop at lower doses, and concludes that identifying an effective dose that spares the kidneys may be challenging.