Polymyxin use associated with respiratory arrest.
The polymyxins (polymyxin B and E) are bactericidal polypeptide antibiotics first discovered in 1947 and used for the treatment of gram-negative bacterial infections. Renal and neurologic toxicities coupled with the increasing availability of effective alternatives led to declining use in the 1960s. The emergence of multidrug-resistant organisms in the past decade has resulted in a resurgence in the use of polymyxins in critically ill patients, yet the side effects are not well known. We report two cases of respiratory arrest likely due to polymyxin B infusions in the context of a 10-fold increase in the use of polymyxin B in our institution over the past 10 years.
Department of Anesthesiology, Columbia University, New York, NY; Department of Epidemiology, Columbia University, New York, NY. Electronic address: hw2125@columbia.edu.
Hannah
H
Wunsch
Department of Anesthesiology, Columbia University, New York, NY.
Vivek K
VK
Moitra
Department of Pharmacy, New York-Presbyterian Hospital, New York, NY.
Mona
M
Patel
Department of Pharmacy, New York-Presbyterian Hospital, New York, NY.
Amy L
AL
Dzierba
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007442:Intubation, Intratracheal; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology; D011112:Polymyxin B / Q000009:adverse effects* / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D011112:Polymyxin B