The increasing prevalence of multi-
drug resistant Gram-negative pathogens in intensive care units has led to the revival of
colistin.
Colistin had gone into disrepute in early 1970s because of numerous reports of adverse renal and neurological effects. The renewed interest in
colistin has also revived the discussion about its toxicity. The neurotoxicity reported in literature is usually with higher doses of
colistin. We present a case report of
seizures in a
critically ill-patient, possibly with low dose
colistin. A 47-year-old hypertensive female with chronic kidney disease-5 with
sepsis on
colistimethate sodium 1 million units (80 mg), intravenous once daily, developed
paresthesias and
seizures on 12(th) day of
therapy, which were subsequently controlled after withdrawl of the
drug. To conclude,
colistin should be considered as a cause of convulsions in
critically ill-patients with
renal failure, even when given in low dose and patient receiving intermittent
hemodialysis, when other obvious causes have been ruled out. When possible, cessation of
therapy may be considered.