Possible Interaction: Acetylcysteine and Colistin

“Combined NAC plus colistin seems to have a beneficial role in restoring oxidant injury which may be related to its antioxidant effect.”

“The cytotoxicity of CMS could be reduced with 10 mM N-acetyl-cysteine.”

“The combined treatment of colistin plus NAC seems to have a beneficial role in restoration of the oxidant injury which may be related to its antioxidant effect.”

“Checkerboard assays showed a synergism of colistin/NAC combinations against the strains with colistin Minimum Inhibitory Concentration (MIC) >2 µg/mL (n = 13), suggesting that NAC could antagonize the mechanisms involved in colistin resistance.”

“Nonetheless, time–kill assays revealed that NAC might potentiate colistin activity also in case of lower colistin MICs.”

“We investigated the potential synergism of colistin in combination with N-acetylcysteine (NAC) (a mucolytic agent with antioxidant and anti-inflammatory properties) against S. maltophilia grown in planktonic phase and biofilm.”

“A remarkable antibiofilm synergistic activity of 8 mg/L colistin plus 8000 mg/L N-acetylcysteine was demonstrated with all colistin-resistant and colistin-susceptible strains.”

“Time–kill assays showed a concentration-dependent potentiation of … strains, with eradication of the culture by combinations of N-acetylcysteine … colistin at 2 or 8 mg/L. A static effect during the first 8 h …-susceptible strain exposed to 0.25 × MIC colistin plus 8000 mg/L N-acetylcysteine.”

“We evaluated the association between NAC use and COL-related nephrotoxicity by comparing the incidence of nephrotoxicity in patients receiving colistin with or without adjunctive NAC.”