The Use of Intravenous and Aerosolized Polymyxins for the Treatment of Infections in Critically Ill Patients: A Review of the Recent Literature

• Published in: Clinical medicine & research Vol. 4; no. 2; pp. 138 - 146
• Main Authors: Falagas, Matthew E, Kasiakou, Sofia K, Tsiodras, Sotirios, Michalopoulos, Argyris
• Format: Journal Article
• Language: English
• Published: United States Marshfield Clinic 01.06.2006; 2006. Clinical Medicine & Research
• Subjects: Aerosols; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Colistin - administration & dosage; Colistin - adverse effects; Colistin - therapeutic use; Critical Illness - therapy; Dose-Response Relationship, Drug; Drug Resistance, Multiple, Bacterial; Gram-Negative Bacterial Infections - drug therapy; Humans; Injections, Intravenous; Literature Reviews; Polymyxin B - administration & dosage; Polymyxin B - adverse effects; Polymyxin B - therapeutic use; Polymyxins - administration & dosage; Polymyxins - adverse effects; Polymyxins - therapeutic use
• ISSN: 1539-4182; 1554-6179
• DOI: 10.3121/cmr.4.2.138

Intravenous and aerosolized polymyxins are being used increasingly, especially in the critical care setting, for treating patients with infections due to multidrug-resistant Gram-negative bacteria, mainly Acinetobacter baumannii and Pseudomonas aeruginosa. Recent literature suggests that intravenous colistin and polymyxin B have acceptable effectiveness for the treatment of patients with bacteremia, as well as infections of various systems and organs, including pneumonia, bacteremia, skin and soft tissue, and urinary tract infections. Although data from recent studies have suggested that the toxicity of intravenous polymyxins is probably less than reported in the older literature, caution should be taken to monitor the renal function of patients who receive these antibiotics.