Polymyxins: wisdom does not always come with age.

TitlePolymyxins: wisdom does not always come with age.
Publication TypeJournal Article
Year of Publication2013
AuthorsKassamali Z, Rotschafer JC, Jones RN, Prince RA, Danziger LH
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Date Published2013 Sep

We currently face a lack of new antimicrobial therapies in an era of increasingly common multidrug-resistant (MDR) bacteria. The polymyxins have become last-line treatments for patients with MDR bacterial infections. An increasing body of published literature has attempted to answer questions about dosing, pharmacology, and susceptibility testing of these drugs, yet each takes for granted purity and potency of the 2 available polymyxin products. In the case of polymyxin B, true potency may vary by as much as 40% from the content reported in prescribing information. This poor accuracy is related to quality assurance assays established in the 1940s and currently in use, which have been shown to be significantly flawed in recent investigations. This review discusses the limitations of pharmacological knowledge about polymyxin antimicrobials, the clinical impact of these limitations, and suggestions for further study of these drugs in order to optimize their use clinically.

Alternate JournalClin. Infect. Dis.