Multidrug resistant bugs and Polymyxin B Safety and Efficacy in Neonates
Hospital acquired blood stream infections in critical care setup are an ongoing problem for healthcare organizations, resulting in tremendous increase in treatment costs and hospital stays. Multidrug resistant (MDR) bugs are no more uncommon for the clinicians engaged in critical care areas which often require taking some out of the box measures to cope with. Neonates are a high risk and vulnerable group of patients with underdeveloped physiological features. Drug related harms to the neonates are a potential risk for hospital admitted babies. The therapy for the neonates should be well directed and time bound to ensure the optimal care.
Polymyxin B is a member of old antibiotics invented in early sixties (1). It is a cyclic amphipathic peptide antibiotic showing its effects via altering the cell membrane permeability (1). Sooner after its invention, its systemic use became obsolete from clinical practice due to its high range of renal, neural and other toxicities. In our NICU, Polymyxin B was successfully used to treat MDR GNR infections with high rate of success. The toxicities were limited to electrolyte imbalances, raised creatinine etc. Polymyxin B is also a 50 % cost effective therapeutic option when compared with carbapenems. With the new emerging trends of GNR susceptibility and limited options for their treatment, Polymyxin B is becoming an important antibiotic in this era. The pharmaceutical manufacturers and the health care regulatory agencies should pay attention to this vitally important theraputic option and some well designed randomized controlled trials should be carried out.
1. Zavascki AP, Goldani LZ, Li J, Nation RL. Polymyxin B for the treatment of multidrug-resistant pathogens: a critical review. J Antimicrob Chemother2007 Dec;60(6):1206-15.
Hospital acquired blood stream infections in critical care setup are an ongoing problem for healthcare organizations, resulting in tremendous increase in treatment costs and hospital stays. Multidrug resistant (MDR) bugs are no more uncommon for the clinicians engaged in critical care areas which often require taking some out of the box measures to cope with. Neonates are a high risk and vulnerable group of patients with underdeveloped physiological features. Drug related harms to the neonates are a potential risk for hospital admitted babies. The therapy for the neonates should be well directed and time bound to ensure the optimal care.
Polymyxin B is a member of old antibiotics invented in early sixties (1). It is a cyclic amphipathic peptide antibiotic showing its effects via altering the cell membrane permeability (1). Sooner after its invention, its systemic use became obsolete from clinical practice due to its high range of renal, neural and other toxicities. In our NICU, Polymyxin B was successfully used to treat MDR GNR infections with high rate of success. The toxicities were limited to electrolyte imbalances, raised creatinine etc. Polymyxin B is also a 50 % cost effective therapeutic option when compared with carbapenems. With the new emerging trends of GNR susceptibility and limited options for their treatment, Polymyxin B is becoming an important antibiotic in this era. The pharmaceutical manufacturers and the health care regulatory agencies should pay attention to this vitally important theraputic option and some well designed randomized controlled trials should be carried out.
1. Zavascki AP, Goldani LZ, Li J, Nation RL. Polymyxin B for the treatment of multidrug-resistant pathogens: a critical review. J Antimicrob Chemother2007 Dec;60(6):1206-15.
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Unknown - Friday 25 February 2011
