BACKGROUND: The treatment of infections caused by multidrug-resistant (MDR) Gram-negative organisms poses a therapeutic challenge. The use of polymyxin B has been resurrected specifically for this purpose. PATIENTS AND METHODS: We retrospectively reviewed the clinical and microbiological efficacy, and safety profile of polymyxin B in the treatment of MDR Gram-negative bacterial infections of the respiratory tract. Twenty-five critically ill patients received a total of 29 courses of polymyxin B administered in combination with another antimicrobial agent. RESULTS: Patients were treated with intravenous, and/or aerosolized polymyxin B. Mean duration of polymyxin B therapy was 19 days (range 2-57 days). End of treatment mortality was 21%, and overall mortality at discharge was 48%. Nephrotoxicity was observed in three patients (10%) and did not result in discontinuation of therapy. CONCLUSIONS: Polymyxin B in combination with other antimicrobials can be considered a reasonable and safe treatment option for MDR Gram-negative respiratory tract infections in the setting of limited therapeutic options.
BACKGROUND: The treatment of infections caused by multidrug-resistant (MDR) Gram-negative organisms poses a therapeutic challenge. The use of polymyxin B has been resurrected specifically for this purpose. PATIENTS AND METHODS: We retrospectively reviewed the clinical and microbiological efficacy, and safety profile of polymyxin B in the treatment of MDR Gram-negative bacterial infections of the respiratory tract. Twenty-five critically illpatients received a total of 29 courses of polymyxin B administered in combination with another antimicrobial agent. RESULTS:Patients were treated with intravenous, and/or aerosolized polymyxin B. Mean duration of polymyxin B therapy was 19 days (range 2-57 days). End of treatment mortality was 21%, and overall mortality at discharge was 48%. Nephrotoxicity was observed in three patients (10%) and did not result in discontinuation of therapy. CONCLUSIONS: Polymyxin B in combination with other antimicrobials can be considered a reasonable and safe treatment option for MDR Gram-negative respiratory tract infections in the setting of limited therapeutic options.
Authors: Vincent H Tam; Amy N Schilling; Giao Vo; Samer Kabbara; Andrea L Kwa; Nathan P Wiederhold; Russell E Lewis Journal: Antimicrob Agents Chemother Date: 2005-09 Impact factor: 5.191
Authors: Federico Perez; Andrea M Hujer; Kristine M Hujer; Brooke K Decker; Philip N Rather; Robert A Bonomo Journal: Antimicrob Agents Chemother Date: 2007-07-23 Impact factor: 5.191
Authors: Kady Phe; Yuman Lee; Patrick M McDaneld; Nishant Prasad; Taijun Yin; Deborah A Figueroa; William L Musick; Jessica M Cottreau; Ming Hu; Vincent H Tam Journal: Antimicrob Agents Chemother Date: 2014-02-24 Impact factor: 5.191