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ESCMID Consensus Statements


The polymyxin antibiotics colistin (polymyxin E) and polymyxin B became available in the 1950s and thus did not undergo contemporary drug development procedures. Their clinical use has recently resurged, assuming an important role as salvage therapy for otherwise untreatable gram-negative infections. Since their reintroduction into the clinic, significant confusion remains due to the existence of several different conventions used to describe doses of the polymyxins, differences in their formulations, outdated product information, and uncertainties about susceptibility testing that has led to lack of clarity on how to optimally utilize and dose colistin and polymyxin B. We report consensus therapeutic guidelines for agent selection and dosing of the polymyxin antibiotics for optimal use in adult patients, as endorsed by the American College of Clinical Pharmacy (ACCP), Infectious Diseases Society of America (IDSA), International Society of Anti-Infective Pharmacology (ISAP), Society for Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP). The European Society for Clinical Microbiology and Infectious Diseases (ESCMID) endorses this document as a consensus statement. The overall conclusions in the document are endorsed by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). We established a diverse international expert panel to make therapeutic recommendations regarding the pharmacokinetic and pharmacodynamic properties of the drugs and pharmacokinetic targets, polymyxin agent selection, dosing, dosage adjustment and monitoring of colistin and polymyxin B, use of polymyxin-based combination therapy, intrathecal therapy, inhalation therapy, toxicity, and prevention of renal failure. The treatment guidelines provide the first ever consensus recommendations for colistin and polymyxin B therapy that are intended to guide optimal clinical use.


Link to publication

Peter Malfertheiner, Francis Megraud, Colm A O’Morain, John Atherton,
Anthony T R Axon, Franco Bazzoli, Gian Franco Gensini, Javier P Gisbert,
David Y Graham, Theodore Rokkas, Emad M El-Omar, Ernst J Kuipers, The
European Helicobacter Study Group (EHSG)

Gut 2012;61:646-664

Link to free article on the journal website

MRSA Expert Consensus Documents, 2009

These are the proceedings of three workshops that took place during the MRSA Consensus Conference sponsored by the European Society of Clinical Microbiology and Infectious Diseases (13–14 December 2007).
The authors are practitioners in the field with considerable experience in the prevention and control of healthcare-associated infection (HCAI), including MRSA.
Although it should be clearly stated that expert reports and consensus based on clinical experience should be explicitly labelled as low-quality evidence, there remains a role for expert opinion while better systems for rating the quality of evidence and the strength of existing recommendations are developed and adopted.


Cauda R, Garau, J. New insights concerning methicillin-resistant Staphylococcus aureus disease (editorial). Clin Microbiol Infect 2009 Feb;15(2):109-11.


Workshop 1

Struelens MJ, Hawkey PM, French GL, Witte W, Tacconelli E. Laboratory tools and strategies for methicillin-resistant Staphylococcus aureus screening, surveillance and typing: state of the art and unmet needs. Clin Microbiol Infect 2009 Feb;15(2):112-9.


Workshop 2

Humphreys H, Grundmann H, Skov R, Lucet JC, Cauda R. Prevention and control of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect 2009 Feb;15(2):120-4.


Workshop 3

Garau J, Bouza E, Chastre J, Gudiol F, Harbarth S. Management of methicillin-resistant Staphylococcus aureus infections. Clin Microbiol Infect 2009 Feb;15(2):125-36.


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