Journal Article

Combination therapy with polymyxin B for the treatment of multidrug-resistant Gram-negative respiratory tract infections

Magdalena E. Sobieszczyk, E. Yoko Furuya, Christine M. Hay, Preeti Pancholi, Phyllis Della-Latta, Scott M. Hammer and Christine J. Kubin

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 54, issue 2, pages 566-569
Published in print August 2004 | ISSN: 0305-7453
Published online August 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh369
Combination therapy with polymyxin B for the treatment of multidrug-resistant Gram-negative respiratory tract infections

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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.

Keywords: RTIs; multidrug resistance; polymyxins

Journal Article.  2055 words. 

Subjects: Medical Oncology ; Critical Care

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