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Volume 357:2310-2311 November 29, 2007 Number 22
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Compounded Colistimethate as Possible Cause of Fatal Acute Respiratory Distress Syndrome

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To the Editor: We report a case of pharmacy compounding of the colistin prodrug colistimethate sodium that led to a fatal case of the acute respiratory distress syndrome (ARDS). The patient was a 29-year-old woman with cystic fibrosis who had chronic airway infection with Pseudomonas aeruginosa and moderate lung disease; she was in clinically stable condition. Maintenance therapy was initiated with 75 mg of inhaled colistimethate sodium delivered twice daily by means of an electronic vibrating plate nebulizer. The patient's respiratory symptoms increased within hours after the first dose. Three days after the initiation of treatment, she required urgent hospital . . . [Full Text of this Article]



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