The antibiotics used were
polymyxin B (PB 300mg), doxycycline (DO 30mg), gentamicin (CN 10mg), amikacin (AK 30mg), imipenem (IMP 10mg), ciprofloxacin (CIP 5mg), meropenem (MEM 10mg), trime thoprim/sulmethoxazole (SXT 25mg), sulzone (SCF), minocycline (MH 30mg), chloramphenicol (C 30mg), vancomycin (VA 30mg), linezolid (LZD 30mg), erythromycin (E 15mg), ceftazidime (CAZ 30mg), and aztreonam (ATM 30mg).
However, clinicians have reevaluated and endorsed older therapeutic agents such as
polymyxin B, a bactericidal antibiotic derived from Bacillus polymyxa to treat infections by MDR GNB, including Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii (25-28).
Regarded as one of the last resorts,
polymyxin B has been used alternatively in China, especially following the surge of CRKP only susceptible to colistin.
According to the company, the antibacterial class of polymyxins includes the drugs colistin and
polymyxin B, essential antibiotics with potent activity against gram-negative pathogens, including E.
An MIC of 24 mg/L was found for
polymyxin B by using the E-test method (
Polymyxin B E-test strip; bioMerieux, Marcy L'Etoile, France).
Given increasing use of
polymyxin B in clinical settings, in this review, we provide current literature evidence of
polymyxin B use as monotherapy and combination therapy for MDR and XDR Gram-negative infections.
We present the first reported case of an infected patient with Klebsiella pneumoniae harboring KPC enzymes, who developed postoperative lumbar wound infection and bacteremia, treated with ceftazidime-avibactam in combination with
polymyxin B and rifampin and without removal of associated hardware.
Higher incidence of acute kidney injury with intravenous colistimethate sodium compared with
polymyxin B in critically ill patients at a tertiary care medical center.
All isolates were multi-drug resistant and had a resistance rate of more than 70 Percent to most antibiotics, except
polymyxin B.
Polymyxin B is a cationic polypeptide antibiotic with activity against gram-negative bacteria and a high affinity to endotoxin, but its intravenous use has been limited due to nephrotoxicity and neurotoxicity [23].
FDA approval of
polymyxin B for injection, USP, an antibacterial drug, in 500,000 units per vial, latex-free glass vials.