Polymyxin B
Also known as: Aerosporin, PMB, Poly-Rx, PolyBactin, Polymyxin B sulfate
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Summary
Polymyxin B is a cyclic cationic peptide antibiotic used intravenously or topically for infections caused by multidrug‑resistant Gram‑negative bacteria.
Mechanism of Action
Binds lipopolysaccharide and phospholipids of Gram‑negative bacterial outer membrane, disrupting membrane integrity and causing cell death
Routes of Administration
Goals & Uses
- Topical skin/eye infection treatmentAntibacterialHigh
- Treatment of MDR Gram-negative infectionsAntimicrobialModerate
- Treatment of Gram‑negative bacterial infectionsAntibacterialHigh
- Treatment of Pseudomonas aeruginosa infectionsAntibacterial TherapyModerate
- Endotoxin neutralizationImmunomodulatoryLow
- Treatment of Acinetobacter baumannii infectionsAntibacterialModerate
Contraindications
- Concurrent use of other nephrotoxic agents (systemic)Drug InteractionHigh
- Hypersensitivity to polymyxinsAllergyHigh
- Severe renal impairmentOrganModerateKidney function concerns
- Known hypersensitivity to polymyxinsAllergyHigh
- Severe renal impairment (systemic use)Organ ImpairmentHigh
- Concurrent use of neuromuscular blocking agentsDrug InteractionHigh
Adverse Effects
- Hypersensitivity reactionsImmunologicRare
- NeurotoxicityNeurologicalUncommon
- Injection site pain/phlebitisLocalCommon
- Electrolyte disturbancesMetabolicUncommon
- SuperinfectionInfectiousUncommon
- NephrotoxicityRenalCommon
Drug Interactions
- AminoglycosidesHigh
- Other nephrotoxic agents (e.g., aminoglycosides, vancomycin)Moderate
- Neuromuscular blocking agentsModerate
- VancomycinModerate
- NSAIDsModerateMay increase renal risk in susceptible patients
- Neuromuscular blocking agents (e.g., vecuronium, succinylcholine)High
- Loop diuretics (e.g., furosemide)Moderate
Population Constraints
- PregnancyReproductive SafetyRelative
- Renal impairmentOrgan ImpairmentRelative
- Pediatric patientsAgeRelative
- Myasthenia gravisNeuromuscular DiseaseRelative
- Elderly patientsAgeRelative
- Pregnant womenReproductiveRelative
Regulatory Status
- European UnionApprovedApproved: Severe Gram‑negative infections, Topical ophthalmic and dermatologic formulationsSame safety considerations as US
- United StatesApprovedApproved: Complicated skin and skin‑structure infections, Urinary tract infections, Inhalation therapy for cystic fibrosisAvailable as injectable solution and topical ointment; restricted use due to toxicity
- United KingdomApprovedApproved: Serious Gram-negative infections caused by susceptible organisms, Topical combination antibiotic productsAvailable in the UK; systemic use primarily as last-resort therapy for MDR infections; MHRA-regulated
Restricted to severe infections due to nephro‑ and neurotoxicity; monitored dosing and renal function required.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Polymyxin B?
Polymyxin B is a cyclic cationic peptide antibiotic used intravenously or topically for infections caused by multidrug‑resistant Gram‑negative bacteria.
What is Polymyxin B used for?
Polymyxin B is educationally associated with: Topical skin/eye infection treatment, Treatment of MDR Gram-negative infections, Treatment of Gram‑negative bacterial infections, Treatment of Pseudomonas aeruginosa infections, Endotoxin neutralization, Treatment of Acinetobacter baumannii infections. Educational only — not medical advice.
How is Polymyxin B administered?
Recorded routes of administration: Inhalation, Intramuscular, Intrathecal, Intravenous, Ophthalmic, Topical.
What are the potential side effects of Polymyxin B?
Reported adverse effects include: Hypersensitivity reactions, Neurotoxicity, Injection site pain/phlebitis, Electrolyte disturbances, Superinfection, Nephrotoxicity. This list is not exhaustive — consult a qualified clinician.
Who should avoid Polymyxin B?
Recorded contraindications: Concurrent use of other nephrotoxic agents (systemic), Hypersensitivity to polymyxins, Severe renal impairment, Known hypersensitivity to polymyxins, Severe renal impairment (systemic use), Concurrent use of neuromuscular blocking agents. Consult a qualified clinician before use.