Colistin Induced Neurotoxicity in a Patient with End Stage Kidney Disease and Recovery with Conventional Hemodialysis

Abstract

Colistin is widely used in the treatment of multidrug resistant bacterial infections. Nephrotoxicity and neurotoxicity are risks associated with colistin use. We report the case of a 50 year old lady with end stage renal disease, treated with colistin for catheter related blood stream infection and developed muscle weakness and parasthesia. Concomitant use of meropenem may have precipitated neurotoxicity of colistin. Conventional hemodialysis was effective in reversing her signs and symptoms. Clinicians should be aware of the risk of neurotoxicity while using colistin, especially after a loading dose in patients with renal impairment. According to our knowledge, this is the first report of conventional hemodialysis reversing the neurotoxic effects of colistin.