What is the equivalent dose of 0.075 million units (MU) of colistin in International Units (IU) for a pediatric patient with impaired renal function?

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Colistin Dose Conversion: 0.075 MU vs 75,000 IU

0.075 million units (MU) and 75,000 International Units (IU) are exactly the same dose—these are simply two different ways of expressing the identical amount of colistin. 1

Understanding the Conversion

  • 1 million units = 1,000 IU 1
  • Therefore, 0.075 MU × 1,000 = 75,000 IU 1
  • Both expressions refer to the same quantity of colistin base activity 1

Critical Context for Pediatric Dosing with Renal Impairment

Since you're asking about pediatric patients with impaired renal function, here's what matters clinically:

Loading Dose (Always Full Dose Regardless of Renal Function)

  • Always administer the full loading dose of 0.15 MU/kg (150,000 IU/kg) regardless of renal impairment 2
  • Never reduce the loading dose in renal dysfunction—this is a critical error that leads to delayed therapeutic levels 2

Maintenance Dose Adjustments Based on Creatinine Clearance

For pediatric patients, adjust only the maintenance doses based on renal function 2:

  • Normal renal function (CrCl ≥80 mL/min): 0.075 MU/kg (75,000 IU/kg) every 12 hours 2
  • Moderate impairment (CrCl 30-49 mL/min): 2.5 mg CBA/kg once daily 2
  • Severe impairment (CrCl 10-29 mL/min): 1.5 mg CBA/kg every 36 hours 2

Conversion Between Units

The FDA label states that each 150 mg vial reconstituted provides 75 mg/mL colistin base activity 3. The relationship between different colistin units can cause dosing errors, so always verify which unit system your institution uses 1.

Mandatory Monitoring

  • Monitor renal function 2-3 times per week during therapy 2, 4
  • Nephrotoxicity occurs in 5.8% of pediatric patients 2, 5
  • Do not underdose to prevent nephrotoxicity—subtherapeutic levels cause treatment failure while still carrying nephrotoxic risk 2, 4

Critical Pitfall to Avoid

Never use colistin as monotherapy for serious infections—always combine with at least one additional active agent 2, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Colistin Dosing Considerations in Pediatric Patients with Renal Impairment

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Colistin Nephrotoxicity

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Colistin Dosing Guidelines for Neonates

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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