Colistin TZF 1,000,000 IU solution for injection, 20 vials: profile, composition and research

Reference page for Colistin TZF 1,000,000 IU solution for injection, 20 vials. Active substance: Колистиметат натрия (колистин) / Colistimethate sodium (colistin).

Key facts

What colistimethate sodium is

Colistin belongs to the polymyxins, an older group of antibiotics introduced in the middle of the last century. Concern about its effect on the kidneys pushed it out of routine use for decades, yet the spread of bacteria resistant to almost everything else brought it back.

The active substance is colistimethate sodium, a prodrug that is gradually converted in the body into active colistin. One vial holds 1,000,000 IU, roughly 80 mg of the substance, and a pack contains 20 vials.

Colistin acts mainly on Gram-negative organisms. These include Pseudomonas aeruginosa, Haemophilus influenzae and other pathogens that are being found in hospital settings ever more often.

How colistin works

The target

Colistin molecules bind to lipids of the outer membrane of the bacterial cell, displacing magnesium and calcium ions. The envelope of the organism loses its stability as a result.

Death of the bacterium

Damage to the membrane leads to leakage of the cell contents and rapid death. The effect is called bactericidal: the medicine destroys the organism rather than merely halting its division.

Why the spectrum is narrow

Colistin has almost no action on Gram-positive bacteria or on anaerobes. It is therefore used in a targeted way, once the pathogen is identified or other treatment options are exhausted.

Approved uses

The prescribing information describes two main routes. Given intravenously, the medicine is used for severe systemic infections caused by susceptible Gram-negative bacteria; these include hospital-acquired pneumonia and cases where the choice of available agents is limited.

By inhalation, colistin is used for chronic lung infection caused by Pseudomonas aeruginosa. This matters especially for people with cystic fibrosis and for those with bronchiectasis unrelated to cystic fibrosis.

The list of indications and the route of administration are decided by a physician after culture and susceptibility testing. Treating yourself with an antibiotic of this group is not acceptable: without precise laboratory data the choice cannot be made.

Why medical supervision is needed

Colistin affects the kidneys, so tests are checked during treatment and the regimen is revised when necessary. Dizziness, speech and vision disturbances, confusion, seizures and allergic skin reactions are also possible.

Inhaled use may cause bronchospasm, a feeling of chest tightness, and irritation of the mouth and throat. If breathing becomes harder, medical help is needed without delay.

Colistin interacts with medicines that burden the kidneys or act on the nervous system, and also with muscle relaxants and agents used for general anaesthesia. Your doctor should be told about every product you take beforehand.

Published research

Primary sources, verified against PubMed:

• Inhaled colistimethate sodium in patients with bronchiectasis and Pseudomonas aeruginosa infection: results of PROMIS-I and PROMIS-II, two randomised, double-blind, placebo-controlled phase 3 trials assessing safety and efficacy over 12 months, PubMed 39270696 (The Lancet. Respiratory medicine, 2024).
• Eradication of Pseudomonas aeruginosa with inhaled colistin in adults with non-cystic fibrosis bronchiectasis, PubMed 31480862 (Chronic respiratory disease, 2019).
• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis, PubMed 37268599 (The Cochrane database of systematic reviews, 2023).

Listed for reference. Publication of a study is not a claim about this particular product.

Precautions

• This is a prescription medicine. Prescribing, dosing and monitoring belong to a physician.
• The solution is prepared and given by healthcare professionals. Self-administered injections and inhalations are not acceptable.
• The main limitation concerns the kidneys: their function is checked before treatment starts and while the course continues.
• Myasthenia gravis, porphyria, bronchial asthma and reduced kidney function require particular caution and a separate assessment by a doctor.
• Allergy to colistimethate sodium or to other polymyxins is a contraindication.
• Use during pregnancy or breastfeeding is discussed with a doctor individually.

Frequently asked