Colistin and its role in the Era of antibiotic resistance: an extended review(2

摘要

Increasing antibiotic resistance in multidrug-resistant (MDR) Gram-negative bacteria(MDR-GNB) presents significant health problems worldwide, since the vital available andeffective antibiotics, including; broad-spectrum penicillins, fluoroquinolones,aminoglycosides, and β-lactams, such as; carbapenems, monobactam, and cephalosporins;often fail to fight MDR Gram-negative pathogens as well as the absence of new antibioticsthat can defeat these “superbugs”. All of these has prompted the reconsideration of olddrugs such as polymyxins that were reckoned too toxic for clinical use. Only twopolymyxins, polymyxin E (colistin) and polymyxin B, are currently commercially available.Colistin has re-emerged as a last-hope treatment in the mid-1990s against MDRGram-negative pathogens due to the development of extensively drug-resistant GNB.Unfortunately, rapid global resistance towards colistin has emerged following itsresurgence. Different mechanisms of colistin resistance have been characterized, includingintrinsic, mutational, and transferable mechanisms.