Polymyxin B: a new strategy for multidrug-resistant Gram-negative organisms.
BACKGROUND
There has been a renewed interest in using polymyxin B as a last resort therapeutic option, due to emergence of multidrug-resistant Gram-negative bacteria. Despite being available for clinical use for decades, there is still a very limited understanding on many aspects of this agent.


OBJECTIVE
To review what is known about polymyxin B and to identify missing information or gaps for future investigations.


METHODS
Pertinent information was reviewed from published literature in English.


CONCLUSIONS
For optimal use of polymyxin B, a more thorough understanding is needed on standardized susceptibility testing, serum and tissue concentrations achieved, antibacterial activity when polymyxin B is combined with other agents, and mechanisms of resistance. A more precise characterization of the relationship between drug concentration and toxicity is also required.
Yuan
Zhe
Z
Chongqing Medical University, The First Affiliated Hospital, Department of Infectious Diseases, Chongqing 400016, China.
Tam
Vincent H
VH
D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D011112:Polymyxin B / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D011112:Polymyxin B