Polymyxins: Wisdom does not always come with age

Zahra Kassamali, John C Rotschafer, Ronald N. Jones, Randall A. Prince, Larry H. Danziger

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)877-883
Number of pages7
JournalClinical Infectious Diseases
Volume57
Issue number6
DOIs
StatePublished - Sep 15 2013

Fingerprint

Polymyxins
Pharmacology
Polymyxin B
Bacterial Infections
Pharmaceutical Preparations
Bacteria
Therapeutics

Keywords

  • microbial sensitivity tests
  • polymyxins/pharmacology
  • polymyxins/therapeutic use

Cite this

Kassamali, Z., Rotschafer, J. C., Jones, R. N., Prince, R. A., & Danziger, L. H. (2013). Polymyxins: Wisdom does not always come with age. Clinical Infectious Diseases, 57(6), 877-883. https://doi.org/10.1093/cid/cit367

Polymyxins : Wisdom does not always come with age. / Kassamali, Zahra; Rotschafer, John C; Jones, Ronald N.; Prince, Randall A.; Danziger, Larry H.

In: Clinical Infectious Diseases, Vol. 57, No. 6, 15.09.2013, p. 877-883.

Research output: Contribution to journalReview article

Kassamali, Z, Rotschafer, JC, Jones, RN, Prince, RA & Danziger, LH 2013, 'Polymyxins: Wisdom does not always come with age', Clinical Infectious Diseases, vol. 57, no. 6, pp. 877-883. https://doi.org/10.1093/cid/cit367
Kassamali, Zahra ; Rotschafer, John C ; Jones, Ronald N. ; Prince, Randall A. ; Danziger, Larry H. / Polymyxins : Wisdom does not always come with age. In: Clinical Infectious Diseases. 2013 ; Vol. 57, No. 6. pp. 877-883.
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