colistin + imipenem (University of Tunis)

This combination therapy involves the use of colistin and imipenem for the treatment of ventilator-associated pneumonia (VAP) caused by multidrug-resistant gram-negative bacilli. Colistin, a polymyxin antibiotic, acts as a detergent-like agent that disrupts the integrity of the bacterial outer membrane by interacting with lipopolysaccharides (LPS) and phospholipids. Imipenem, a carbapenem antibiotic, inhibits the final transpeptidation step of peptidoglycan synthesis by binding to penicillin-binding proteins (PBPs), thereby preventing bacterial cell wall formation. The specific regimen studied by Tunis University compares the administration of aerosolized colistin against intravenous colistin, both in combination with intravenous imipenem, to optimize local drug concentration in the lungs while minimizing systemic toxicities such as nephrotoxicity.

Brand names

Colimycin

Other names

Aerosolised colistin + imipenemIV colistin + imipenem