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AntimicrobialFDA Approved

Polymyxin B

Overview

Polymyxin B is a cyclic lipopeptide antibiotic derived from Bacillus polymyxa, consisting of a heptapeptide ring and a tripeptide side chain acylated with a fatty acid tail. The molecule binds to lipopolysaccharide in the outer membrane of Gram-negative bacteria, causing membrane permeabilization and cell death. Its cationic residues interact electrostatically with anionic phosphate groups on lipid A. Polymyxin B is reserved for serious infections caused by multidrug-resistant Gram-negative pathogens when other options are unavailable.

Key Research Findings

Polymyxin B received FDA approval in the 1960s and remains in clinical use for severe infections caused by carbapenem-resistant Enterobacteriaceae and Acinetobacter species. Nephrotoxicity and neurotoxicity limit its use, prompting development of dosing protocols based on therapeutic drug monitoring. Recent pharmacokinetic studies have refined dosing strategies to optimize efficacy while minimizing adverse renal effects.

Route of Administration

Intravenous, Intrathecal, Topical

Regulatory Status

FDA Approved

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