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August 11, 1969, Vol 209, No. 6 >
ARTICLE | August 11, 1969

Colistimethate Toxicity

R. M. Gabrielson, MD
JAMA. 1969;209(6):943. doi:10.1001/jama.1969.03160190065035.
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ABSTRACT

To the Editor:—  Publication of case reports calling attention to drug toxicity is certainly worthwhile. We, therefore, fully endorse publication of "Colistimethate Toxicity: Report of a Fatal Case in a Previously Healthy Child" (207:2099, 1969).However, we feel that the title was poorly chosen because it fails to convey the key concept of "overdosage" or "misuse." Neither word appears in the title which leaves a false impression with the casual reader who may be only scanning headlines.Serious reactions to colistimethate sodium rarely, if ever, occur when our current recommendations are followed, and these are revised as experience indicates.The authors report the colistimethate sodium dose as 30 mg/kg every six hours. This is 120 mg/kg/ day whereas the maximum recommended dose is only 5 mg/kg/day! Thus, the dosage in this case was 24 times the maximum recommended dose.

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