Megabac (Colistimethate Sodium Injection)| Potent Last-Resort Antibiotic for Multi-Drug Resistant Gram-Negative Infections
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Megabac is indicated for treating acute and chronic infections caused by susceptible strains of Gram-negative bacteria, particularly in life-threatening infections caused by Pseudomonas aeruginosa. It is also effective against:
⚠️ Megabac is not indicated for infections caused by Proteus or Neisseria species.
Megabac (Colistimethate Sodium) is a polycationic surface-active agent that disrupts the bacterial outer membrane, increasing permeability and leading to cell death. It binds to lipopolysaccharides and phospholipids, displacing stabilizing ions and ultimately causing bacterial lysis. It may also precipitate cytoplasmic components inside the bacterial cell.
Maintenance dose: 9 MIU/day divided into 2–3 doses
Critically ill patients: Loading dose of 9 MIU is recommended
CrCl <50–30 ml/min: 5.5–7.5 MIU/day
CrCl <30–10 ml/min: 4.5–5.5 MIU/day
CrCl <10 ml/min: 3.5 MIU/day
Hemodialysis patients:
Non-HD days: 2.25 MIU/day
HD days: 3 MIU/day (post-dialysis)
≤40 kg: 75,000–150,000 IU/kg/day in 3 divided doses
40 kg (e.g., children with cystic fibrosis): higher doses may be required (>150,000 IU/kg/day)
Dose should be based on lean body weight
Reconstitute the vial with 5 mL of water for injection
For infusion: dilute in 50–100 mL 0.9% sodium chloride
Infuse over 30–60 minutes
Reconstitute with 2 mL of water for injection
Administer into a large muscle mass
First, inject half the dose over 3–5 minutes
Add the second half to an appropriate IV solution and infuse over the next 22–23 hours
Use only with compatible diluents: 0.9% NaCl, 5% Dextrose variants, or Lactated Ringer’s
📌 Use reconstituted solution within 24 hours; do not mix with other drugs in the same IV line.
Serious:
IM: Reconstitute with 2 mL of water for injection
IV bolus: Reconstitute with 5 mL of water for injection
IV infusion: Dilute reconstituted vial in 50–100 mL 0.9% NaCl
🕒 Use reconstituted solution within 24 hours; store at 2°C–8°C; do not freeze
Symptoms may include:
Hypersensitivity to colistimethate sodium or any formulation component
Pregnancy Category C: Use only if benefits outweigh fetal risks
Unknown if excreted in human milk – caution in breastfeeding
⚠️Disclaimer:
At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.