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 patientís 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

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