Polymyxin B: A New Strategy for Multidrug-Resistant Gram-negative Organisms

Expert Opin Investig Drugs. 2008 May;17(5):661-8. doi: 10.1517/13543784.17.5.661.


Background: There has been a renewed interest in using polymyxin B as a last resort therapeutic option, due to emergence of multidrug-resistant Gram-negative bacteria. Despite being available for clinical use for decades, there is still a very limited understanding on many aspects of this agent.

Objective: To review what is known about polymyxin B and to identify missing information or gaps for future investigations.

Methods: Pertinent information was reviewed from published literature in English.

Results/conclusion: For optimal use of polymyxin B, a more thorough understanding is needed on standardized susceptibility testing, serum and tissue concentrations achieved, antibacterial activity when polymyxin B is combined with other agents, and mechanisms of resistance. A more precise characterization of the relationship between drug concentration and toxicity is also required.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents* / adverse effects
  • Anti-Bacterial Agents* / pharmacokinetics
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Clinical Trials as Topic
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / microbiology
  • Humans
  • Polymyxin B* / adverse effects
  • Polymyxin B* / pharmacokinetics
  • Polymyxin B* / pharmacology
  • Polymyxin B* / therapeutic use


  • Anti-Bacterial Agents
  • Polymyxin B