North America Colistin Market Analysis and Forecast by Size, Share, Growth, Trends 2034

The North America Colistin Market size is expected to reach US$ 71.1 Million by 2034 from US$ 46.3 Million in 2025. The market is estimated to record a CAGR of 5.0% from 2026 to 2034.

Executive Summary and North America Colistin Market Analysis:

The colistin market in North America is growing due to the persistent challenge of multidrug-resistant (MDR) Gram-negative bacterial infections in hospitals and the ongoing need for last-resort antibiotics in human health, alongside regulated but targeted use in animal health. In the US, according to the Centers for Disease Control and Prevention (CDC), the 2023 Antibiotic Resistance Threats Report (with updated data from 2023-2024) indicated that carbapenem-resistant Enterobacterales (CRE) infections caused approximately 13,100 cases and 1,100 deaths in 2022-2023, with colistin frequently used for MDR Pseudomonas aeruginosa and Acinetobacter baumannii in bloodstream infections (BSI), sepsis, lower respiratory tract infections (LRTI), and urinary tract infections (UTIs). In 2024, CDC's National Healthcare Safety Network (NHSN) reported a 5% increase in MDR Gram-negative HAIs in acute care hospitals, boosting colistin injectables (IV/IM) demand in hospital pharmacies. In 2025, CDC projections estimate continued high resistance, enhancing colistin utilization for ventilator-associated pneumonia (VAP) and cystic fibrosis.

New product developments include the FDA's 2024 approval of sulbactam-durlobactam (Xacduro) as a colistin-sparing alternative for MDR Acinetobacter infections, launched to improve outcomes in VAP and BSI. Other instances encompass the CDC's 2025 AMR Action Plan updates, which reported a 3% rise in colistin prescriptions for human health in 2024, emphasizing stewardship for inhalation solutions in tracheobronchitis. The FDA's Veterinary Feed Directive (VFD) in 2023-2024 limited animal colistin use to specific indications like gastrointestinal infections, distributed through retail pharmacies. Additionally, the 2025 HHS AMR strategy supports topical formulations for skin infections via online pharmacies, addressing central nervous system infections with bowel decontamination amid rising MDR prevalence

North America Colistin Market: Strategic Insights

North America Colistin Market Segmentation Analysis:

• By Formulation, the North America Colistin Market is segmented into Injectables (IV or IM), Oral, Topical Formulations, and Inhalation Solutions. The Injectables (IV or IM) segment dominated the market in 2025.
• By Indication, the North America Colistin Market is segmented into Human Health and Animal Health. The Human Health segment dominated the market in 2025.
• By Human Health, the North America Colistin Market is segmented into Bloodstream Infections (BSI) and Sepsis Lower, Respiratory Tract Infections (LRTI), Urinary Tract Infections (UTIs), Central Nervous System Infections, Skin Infections, Cystic Fibrosis, Tracheobronchitis or VAP, Gastrointestinal Infections, and Bowel Decontamination. The Respiratory Tract Infections (LRTI) segment dominated the market in 2025.
• By Distribution Channel, the North America Colistin Market is segmented into Hospital Pharmacy, Retail Pharmacy, Online Channel, and Other Distribution Channel. The Hospital Pharmacy segment dominated the market in 2025.

North America Colistin Market Players Density: Understanding Its Impact on Business Dynamics

The North America Colistin Market is growing rapidly, driven by increasing end-user demand due to factors such as evolving consumer preferences, technological advancements, and greater awareness of the product's benefits. As demand rises, businesses are expanding their offerings, innovating to meet consumer needs, and capitalizing on emerging trends, which further fuels market growth.

North America Colistin Market Outlook

The rising incidence of multidrug-resistant (MDR) Gram-negative bacterial infections positions colistin as a critical last-resort antibiotic for treating severe cases involving pathogens such as Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae. These organisms frequently exhibit resistance to carbapenems and other frontline therapies, forcing clinicians to rely on colistin in intensive care settings for conditions such as ventilator-associated pneumonia, bloodstream infections, and sepsis. As per the National Health Institute’s 2025 report, there was a 43% global increase in MDR infections, with healthcare-associated cases rising by 67% and community-acquired ones by 38%, largely due to antibiotic misuse. As per the same source, Carbapenem-resistant Enterobacteriaceae (CRE) infections show case-fatality rates exceeding 40% in a majority of settings, while colistin resistance in carbapenem-resistant isolates reached 13.4%. As per a Clinical Infectious Diseases study published by Oxford Academic in 2023, carbapenem-resistant Acinetobacter cases in the US numbered 8,500, with 700 deaths. Globally, colistin is listed in emergency drug formularies in over 34 countries for resistant infections. Thus, an increasing prevalence of MDR and surging prevalence of infections are boosting the demand for colistin.

North America Colistin Market Country Insights

By country, the North America Colistin Market is segmented into the United States, Canada, and Mexico. The United States held the largest share in 2025.

In the US, antimicrobial resistance remains a major clinical concern, driving the use of last-line antibiotics like colistin. Official data from the Centers for Disease Control and Prevention indicate that more than 2.8 million antimicrobial-resistant infections occur annually, with tens of thousands of deaths linked to resistant pathogens such as carbapenem-resistant Enterobacterales and other Gram-negative bacteria. Between 2019 and 2023, laboratory surveillance by the CDC's Antimicrobial Resistance Laboratory Network documented sharp increases in carbapenemase-producing isolates, particularly those carrying NDM genes, which complicate therapy and often require colistin as a treatment option when other antibiotics fail. The prominence of resistant Gram-negative infections in both hospital and community settings stimulates clinical reliance on polymyxins like colistin for severe infection management. Colistin remains part of clinical practice guidelines for difficult-to-treat infections where traditional antibiotics are ineffective. Moreover, expanded surveillance and testing via the AR Lab Network have improved detection of high-priority resistant bacteria, contributing to more targeted use of last resort agents.

North America Colistin Market Company Profiles

Some of the key players operating in the market include Livzon Pharmaceutical Group Inc, TZF Polfa S.A., Tecoland Corporation, Fujian Lifecome Biochemistry Limited, Zhejiang Shenghua Biok Chemical Company Limited, Xellia Pharmaceuticals ApS, Shandong LuKang Pharmaceutical Co., Ltd, Apeloa Pharmaceutical Co., Ltd., Norma Hellas S.A, and Hebei Shengxue Dacheng Pharmaceutical Co., Ltd.

These players are adopting various strategies such as expansion, product innovation, and mergers and acquisitions to provide innovative products to their consumers and increase their market share.

North America Colistin Market Research Methodology

The following methodology has been followed for the collection and analysis of data presented in this report:

Secondary Research

The research process begins with comprehensive secondary research, utilizing internal and external sources to gather qualitative and quantitative data for each market. Commonly referenced secondary research sources include, but are not limited to:

• Company websites, annual reports, financial statements, broker analyses, and investor presentations
• Industry trade journals and other relevant publications
• Government documents, statistical databases, and market reports
• News articles, press releases, and webcasts specific to companies operating in the market

Note: All financial data included in the Company Profiles section has been standardized to US$. For companies reporting in other currencies, figures have been converted to US$ using the relevant exchange rates for the corresponding year.

Primary Research

The Insight Partners conducts a significant number of primary interviews each year with industry stakeholders and experts to validate its data analysis and gain valuable insights. These research interviews are designed to:

• Validate and refine findings from secondary research
• Enhance the expertise and market understanding of the analysis team
• Gain insights into market size, trends, growth patterns, competitive dynamics, and future prospects

Primary research is conducted via email interactions and telephone interviews, encompassing various markets, categories, segments, and sub-segments across different regions. Participants typically include:

• Industry stakeholders: Vice Presidents, Business Development Managers, Market Intelligence Managers, and National Sales Managers
• External experts: Valuation specialists, research analysts, and key opinion leaders with industry-specific expertise