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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 17, Issue 5, Pages 267-269
Adult Infectious Disease Notes

Colistin: The phoenix Arises

JM Conly1 and BL Johnston2

1Departments of Pathology and Laboratory Medicine, Medicine, and Microbiology and Infectious Diseases, Centre for Antimicrobial Resistance, University of Calgary, Calgary, Alberta, Canada
2Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada

Received 24 July 2006; Accepted 24 July 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The polymyxins were discovered in the 1940s and represent a group of closely related polypeptide antibiotics obtained from Bacillus polymyxa, which was originally isolated from soil (1,2). Although they have been used extensively worldwide in topical otic and ophthalmic solutions for decades, the intravenous formulations were gradually abandoned in most parts of the world in the early 1980s because of the reported high incidence of nephrotoxicity (3-5). As a result, the use of polymyxin preparations has been mainly restricted to the treatment of lung infections due to multidrug-resistant (MDR) gram-negative bacteria in patients with cystic fibrosis (6,7). The emergence of bacteria resistant to most classes of commercially available antibiotics and the shortage of novel antimicrobial agents with activity against gram-negative microorganisms have led to the reemergence of polymyxins as a valuable addition to the therapeutic armamentarium. It was thus considered timely to review colistin and its emerging role in managing infections due to MDR gram-negative bacteria.