![]() CMS is produced by treating the primary amine groups of the α,γ-diaminobutyric acid residues in colistin with formaldehyde followed by sodium bisulfite. There are two different forms of colistin available commercially, colistin sulfate for oral and topical use and colistimethate sodium (CMS) for parenteral and aerosol therapy. Colistin is a multicomponent polypeptide antibiotic composed mainly of colistin A (polymyxin E1) and colistin B (polymyxin E2) (, 13). aeruginosa has made colistin of interest once more, as it possesses the advantage of rapid bactericidal activity and only slowly leads to the development of resistance (, ). Although the availability of less toxic antipseudomonal antibiotics relegated colistin to the status of a reserve agent, the subsequent development of multidrug resistance in P. Colistin, also known as polymyxin E, was the first antibiotic with notable in vitro activity against P. Serious infections caused by the multidrug-resistant Pseudomonas aeruginosa are a significant clinical problem () and result in high morbidity and mortality among cystic fibrosis patients and immunocompromised hosts (, ). ![]()
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