Polymyxin B sulfate

Polymyxin B Sulfate Injection

Category:

Antibiotic

Description:

Topical anti-infective

Indications:

Acute infections due to P. aeruginosa
Serious infections from H. influenzae, E. coli, Enterobacter aerogenes, Klebsiella pneumoniae)
NOTE: for meningeal infections, administer intrathecally

Contraindications:

None

Precautions:

Pregnancy category B
Monitor patient’s renal function with baseline levels and throughout therapy
May cause neurotoxic reactions such as:
- irritability
- weakness
- drowsiness
- ataxia
- peripheral numbness
- blurred vision
- Severe neurotoxicity may lead to respiratory paralysis if given shortly after anesthesia or muscle relaxants.

Adverse Reactions (Side Effects):

Nephrotoxic:
- albuminuria
- cylindruria
- azotemia
Neurotoxic:
- facial flushing
- dizziness
- drowsiness
- apnea
- peripheral paresthesia
Meningeal irritation in intrathecal administration
Drug fever
Urticarial rash
Severe pain or thrombophlebitis at injection site

Dosage:

Administered by IV or IM injection
IV administration:
- Adults and Children (normal renal function): 15,000-25,000 units/kg/day in divided doses q12h
- Infants: 40,000 units/kg/day
IM administration:
- Adults and Children (normal renal function): 25,000-30,000 units/kg/day in divided doses at 4-6 hour intervals
- Infants: 40,000 units/kg/day
Intrathecal administration:
- Adults and Children (>2 years old) (normal renal function): 50,000 units once daily for 3-4 days, then 50,000 units once every other day for at least two weeks once CSF culture is negative
- Children (<2 years old): 20,000 units once daily, then 25,000 units once every other day for at least two weeks once CSF culture is negative

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300