title: Agents of Last Resort: Polymyxin Resistance.
abstract: Polymyxin resistance is a major public health threat, as the polymyxins represent "last-line" therapeutics for Gram-negative pathogens resistant to essentially all other antibiotics. Improved understanding of mechanisms of, and risk factors for, polymyxin resistance, as well as infection prevention and stewardship strategies, together with optimization of dosing of polymyxins including in combination regimens, can help to limit the emergence and dissemination of polymyxin resistance.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Detroit Medical Center, Wayne State University, 3990 John R, Detroit, MI 48201, USA. Electronic address: kkaye@dmc.org.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
authors.affiliation: Department of Pharmacy Services, Sinai-Grace Hospital, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Pogue
authors.affiliation: Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia.
authors.forename: Thien B
authors.initials: TB
authors.lastname: Tran
authors.affiliation: Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia.
authors.forename: Roger L
authors.initials: RL
authors.lastname: Nation
authors.affiliation: Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
mesh_terms: D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000472:pathogenicity; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D011113:Polymyxins; D011634:Public Health
chemical_list: D011113:Polymyxins
keywords: Colistin; Gram-negative; Polymyxin B; Polymyxins; Resistance