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N-acetylcysteine + colistin is a synergistic pharmacological combination that demonstrates enhanced antibacterial and antibiofilm activity against multidrug-resistant gram-negative bacteria. N-acetylcysteine (NAC) is a mucolytic agent with antioxidant properties, while colistin (polymyxin E) is a polymyxin antibiotic. When combined, NAC potentiates colistin's activity against bacterial biofilms and can potentially reverse colistin resistance in certain bacterial strains. The combination is particularly effective against Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia, including biofilm-associated infections. Additionally, NAC may help prevent colistin-induced nephrotoxicity, a common side effect of colistin therapy.
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