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J Antimicrob Chemother. 2004 Aug;54(2):566-9. Epub 2004 Jul 21.

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

Author information

1
Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, 630 W. 168th Street, PH 8W-876, New York, NY 10032, USA. mes52@columbia.edu

Abstract

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.

PMID:
15269195
DOI:
10.1093/jac/dkh369
[Indexed for MEDLINE]

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