Colimycine

With all this hype about the Orkambi that is apparently a "Cure"for delta F508 mutations, it got me thinking about Colistin.

This is a section 21 medication that I am on, it is my "LAST RESORT".

This medication was made in France and is yet to be approved in South Africa, 10 years after the clinical trials started.

What A Patient has to go through to get this drug is nightmarish. It is more of a headache than someone hitting you over the head with a frying Pan. And yet, what do we "last resort"patients do without it? What options do we have when we are resistant to every other drug available?


Here is what the "South African Medical Journal" had to say about the drug.
And I agree completely, there has not been enough research done on this drug. Not to mention, do our doctors ever send reports back about patients improvements ,

So what makes ORKAMBI Different? Will we still wait 10 years + for it to be approved? There aren't even any prospects of having a Clinical Trial.

So the hope that South African CF's have to get this drug to "cure"us, will not materialize anytime soon.

Here is a snippet out of the SAMJ, click the link to read the whole report.

http://www.ajol.info/index.php/samj/article/viewFile/101538/90729


Background. There is an alarming global increase in the incidence of nosocomial infections with multidrug-resistant Gram-negative bacteria, which are often only susceptible to colistin. Colistin was developed prior to current methods of establishing dosing using pharmacokinetic-pharmacodynamic relationships. Dosing regimens differ in package inserts from different manufacturers and in different guidelines. It is imperative to avoid under-dosing with colistin in order to limit the development of resistance, as it is the last line of defence. Methods. We conducted a systematic review of the literature to develop guidelines for rational dosing of intravenous colistin, with a particular focus on critically ill patients. Results. Colistin is administered as the inactive pro-drug colistimethate sodium. Colistin demonstrates concentration-dependent bacterial killing, suggesting that higher doses should be administered less frequently to achieve higher peak concentrations. Dose-related nephrotoxicity occurs, making it impossible to safely achieve concentrations that prevent the selection of resistant mutants or the effective eradication of bacteria with higher minimum inhibitory concentrations. Theoretically, combination therapy should be used to reduce the risk of selection of resistant bacteria. In critically ill patients, a loading dose should be given to rapidly achieve therapeutic concentrations, followed by maintenance doses of 4.5 MU 12-hourly. Maintenance dose adjustment is necessary with renal impairment. Conclusion. Easier access to colistin is needed in South Africa, where it is not a registered medicine. Further research is needed to better characterise colistin’s pharmacokinetic-pharmacodynamic relationships in humans and to establish whether combinations of colistin with other antimicrobials result in improved clinical outcomes or a reduction in selection of resistant bacteria.