Polymyxin B for the treatment of multidrug-resistant pathogens: a critical review.
By A. Zavascki, L. Goldani, Jian Li, Roger L. Nation. Journal of Antimicrobial Chemotherapy, 2007
809 citations recorded by the source corpus.
Polymyxins have re-emerged in clinical practice owing to the dry antibiotic development pipeline and worldwide increasing prevalence of nosocomial infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Polymyxin B and colistin (polymyxin E) have been ultimately considered as the last-resort treatment of such infections. Microbiological, pharmacokinetic, pharmacodynamic and clinical data available for polymyxin B are reviewed in this paper. Polymyxin B has rapid in vitro bactericidal activity against major MDR Gram-negative bacteria, such as Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae. Acquired resistance to this agent is still rare among these pathogens. However, optimized dosage regimens are not known yet. Good clinical outcomes have been observed in the majority of the patients treated with intravenous polymyxin B in recent studies. However, these studies failed to provide definitive conclusions due to limitations of study design and additional clinical trials are required. Although combination therapy may be an attractive option based on some currently available in vitro data, clinical data supporting such recommendations are lacking. Since polymyxins will be increasingly used for the treatment of infections caused by MDR bacteria, clinical pharmacokinetic, pharmacodynamic and toxicodynamic studies underpinning the optimal use of these drugs are urgently required.
Subfields: Epidemiology, Molecular Medicine, Pharmacology
View Paper: https://www.semanticscholar.org/paper/d60c8053562b93a619edf180c900b0aded615b49
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Citations in the corpus
- Contribution of bacterial outer membrane vesicles to innate bacterial defense (2011, background): “Because of their generic target and their speed of action, AMPs have recently been revisited in the quest to develop novel antibiotics against Gram-positive and Gram-negative pathogens [14,19-22].”
- Mechanisms and consequences of bacterial resistance to antimicrobial peptides. (2016, background): “There are only a handful of AMPs currently in clinical use, and of these, polymyxin B and colistin (polymyxin E) are the most characterized in a clinical setting (Falagas and Kasiakou, 2005; Landman et al., 2008; Zavascki et al., 2007).”
- Antimicrobial Peptides: An Emerging Category of Therapeutic Agents (2016, background): “Polymyxins are last-resort drugs for intravenous treatment of drug-resistant infections caused by Gram-negative pathogens, but they are also applied as topical formulations in the prevention and treatment of local infections (Zavascki et al., 2007).”