Klinička uporaba kolistina: pregled aktualnih smjernica i istraživanja koja teže povećanju njegovog kliničkog "roka trajanja"

master's thesis

• Title (english): Clinical utilization of colistin: a review of current clinical guidelines and research aiming to increase its clinical lifespan
• Author: Vanessa Vana Rogga
• Mentor: Ivan Kosalec (mentor)
• Committee member: Ivan Kosalec (predsjednik povjerenstva)
• Committee member: Iva Mucalo (član povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of microbiology); Zagreb
• Defense date and country: 2023-06-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Kolistin (polimiksin E) je ciklički kationski lipodekapeptidni antibiotik čiji mehanizam djelovanja
uključuje narušavanje integriteta stanične membrane gram-negativnih bakterija. Kolistin je u
kliničku praksu ušao sredinom 20. stoljeća, no njegova je primjena zbog nefrotoksičnosti i
neurotoksičnosti napuštena već desetak godina nakon uvođenja u kliniku. U današnje vrijeme AMR
postaje rastući zdravstveni problem zbog kojeg ponestaje terapijskih opcija za liječenje životno
ugrožavajućih infekcija. Zato je kolistin pronašao svoje mjesto u klinici kao rezervni antibiotik s
obzirom na to da je trenutno stopa rezistencije na kolistin relativno niska. S obzirom na to da je
kolistin u humanoj medicini dugo bio opsolentan tek su 2019. godine donesene kliničke smjernice
za uporabu kolistina koje su konsenzus relevantnih svjetskih kliničkih društava. Iz literature je uočen
je trend porasta potrošnje kolistina u bolničkim sredinama u RH u periodu od 2011.-2021. Stoga
zabrinjava i mogućnost porasta stope rezistencije na kolistin u bliskoj budućnosti. Kako bi se očuvala
klinička efikasnost kolistina trenutno se razvijaju brze dijagnostičke metode za rano otkrivanje
rezistencije na kolistin te se istražuju potencijalni adjuvantni terapeutici za kolistin.

Abstract (english)

Colistin (polymyxin E) is a cyclic cationic lipodecapeptide antibiotic. Its mechanism of action
involves the disruption of the cellular membrane of Gram-negative bacteria. Colistin has been
discovered in 1947. Due to its high nephrotoxicity and neurotoxicity, its clinical use has been
abandoned already a decade after its discovery. AMR is a growing public health issue, as there are
currently few therapeutic options for treating life-threatening infections. Colistin has recently been
re-introduced for clinical use due to its low resistance rates at the moment. In 2019., the first
consensus clinical guidelines among relevant global clinical societies have been published.
Literature has shown an increase in the clinical use of colistin in Croatian hospitals over the period
2011.-2021. Therefore, it is concerning that colistin resistance rates might increase over the
following years. To increase colistin’s clinical lifespan, researchers are developing diagnostic
methods for early resistance diagnostics and searching for potential adjuvant therapeutics for
colistin.

• Keywords: kolistin; antimikrobna rezistencija; lipid A
• Keywords (english): colistin; antimicrobial resistance; lipid A
• Language: croatian
• URN:NBN: urn:nbn:hr:163:752692
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Embargoed access; Embargo expiration date: 2025-06-20
• Created on: 2023-10-31 08:54:32