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