Polymyxin B



  • Polymyxin Antibiotic (see Polymyxins, [[Polymyxins]])


  • IV:
  • Topical:
  • Subconjunctival:

Adverse Effects

  • Neuromuscular Junction Antagonism with Respiratory Muscle Weakness (see Acute Hypoventilation, [[Acute Hypoventilation]] and Chronic Hypoventilation, [[Chronic Hypoventilation]])
    • Risk Factors for Neuromuscular Junction Antagonism
      • Intraperitoneal Adminsistration
      • Intrapleural Administartion
      • Chronic Kidney Disease (CKD)
      • Associated Use of Paralytics
    • Treatment: may respond to physostigmine

Renal Adverse Effects


  • Characterization of polymyxin B-induced nephrotoxicity: implications for dosing regimen design. Antimicrob Agents Chemother. 2012 Sep;56(9):4625-9 [MEDLINE]
  • Pharmacology of polymyxins: new insights into an ‘old’ class of antibiotics. Future Microbiol. 2013 Jun;8(6):711-24 [MEDLINE]
  • Higher Incidence of Acute Kidney Injury With Intravenous Colistimethate Sodium Compared With Polymyxin B in Critically Ill Patients at a Tertiary Care Medical Center. Clin Infect Dis. 2013 Nov;57(9):1300-1303 [MEDLINE]