Synergistic combinations of polymyxins

Int J Antimicrob Agents. 2016 Dec;48(6):607-613. doi: 10.1016/j.ijantimicag.2016.09.014. Epub 2016 Oct 24.

Abstract

The proliferation of extensively drug-resistant Gram-negative pathogens has necessitated the therapeutic use of colistin and polymyxin B. However, treatment failures with polymyxin monotherapies and the emergence of polymyxin resistance have catalysed the search for polymyxin combinations that synergistically kill polymyxin-susceptible and -resistant organisms. This mini-review examines recent (2011-2016) in vitro and in vivo studies that have attempted to identify synergistic polymyxin combinations against Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. Clinical evidence for the use of combination regimens is also discussed.

Keywords: Acinetobacter baumannii; Combinations; Klebsiella pneumoniae; Polymyxins; Pseudomonas aeruginosa; Synergy.

Publication types

  • Review

MeSH terms

  • Acinetobacter baumannii / drug effects*
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Drug Synergism*
  • Drug Therapy, Combination / methods
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Klebsiella pneumoniae / drug effects*
  • Polymyxins / pharmacology*
  • Polymyxins / therapeutic use
  • Pseudomonas aeruginosa / drug effects*

Substances

  • Anti-Bacterial Agents
  • Polymyxins