polymixin B (Aerosporin)
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Introduction
Tradename: Aerosporin.
Indications
- bacterial infections due to susceptible organisms
- topical application only
- lower urinary tract infections due to resistant gram negative bacilli, including carbapenem-resistant
- otitis externa[4]
Dosage
- bladder irrigation 250,000 units in 1 liter of normal saline continuously over 24 hours
Pharmacokinetics
topical use only
elimination via liver
elimination via kidney
1/2life = 6 hour
Antimicrobial activity
* No gram-positive or anti-fungal activity
Adverse effects
Mechanism of action
- bactericidal
- binds to phosphate groups in the lipids of bacterial cytoplasmic membranes causing membrane instability & leakage
- resistance is rare
Notes
- mcr-1 testing of all Enterobacteriaceae isolates with a colistin or polymyxin B minimum inhibitory concentration of 4 ug/mL or higher[5]
- testing can be performed through the CDC
More general terms
Component of
- miconazole/polymixin b/prednisolone
- oxytetracycline/polymixin b
- miconazole/nitrate/polymixin b/prednisolone
- cortisol/polymixin b
- bacitracin/lidocaine/neomycin/polymixin b
- neomycin/polymixin b/prednisolone
- neomycin/polymixin B/pramoxine
- bacitracin/neomycin/polymixin b/pramoxine
- bacitracin/cortisol/neomycin/polymixin b
- cortisol/neomycin/polymyxin B
- gramicidin/neomycin/polymixin-B (Opthneosporin, AK-spore)
- bacitracin/polymixin-B (Polysporin, Ocumycin)
- bacitracin/neomycin/polymixin-B (Neosporin)
- polymixin-B/trimethoprim (Polytrim)
- cortisol/neomycin/polymixin-B (Corticosporin, Cortisporin, Cortomycin)
- cortisol/neomycin/polymyxin B otic (Corticosporin otic, Cortisporin otic)
- dexamethasone/neomycin/polymixin-B (Maxitrol, Dexasporin)
- Neomycin/Polymixin B (Neosporin GU irrigant)
References
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Jump up to: 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 16, American College of Physicians, Philadelphia 2012
- ↑ Chen LF, Kaye D. Current use for old antibacterial agents: polymyxins, rifamycins, and aminoglycosides. Infect Dis Clin North Am. 2009 Dec;23(4):1053-75, PMID: https://www.ncbi.nlm.nih.gov/pubmed/19909897
- ↑ Jump up to: 4.0 4.1 4.2 Deprecated Reference
- ↑ Jump up to: 5.0 5.1 Orciari Herman A, Sadoughi S, Sofair A. CDC: E. Coli Resistant to Last-Resort Antibiotic Again Found in U.S., No Transmission Seen Physician's First Watch, Sept 12, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org