期刊
CLINICAL INFECTIOUS DISEASES
卷 59, 期 1, 页码 88-94出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciu213
关键词
colistin; polymyxin B; differing clinical pharmacological behaviors; therapeutic implications
资金
- NIAID NIH HHS [R01 AI098771, R01AI098771] Funding Source: Medline
Colistin and polymyxin B have indistinguishable microbiological activity in vitro, but they differ in the form administered parenterally to patients. Polymyxin B is administered directly as the active antibiotic, whereas colistin is administered as the inactive prodrug, colistin methanesulfonate (CMS). CMS must be converted to colistin in vivo, but this occurs slowly and incompletely. Here we summarize the key differences between parenteral CMS/colistin and polymyxin B, and highlight the clinical implications. We put forth the view that overall polymyxin B has superior clinical pharmacological properties compared with CMS/colistin. We propose that in countries such as the United States where parenteral products of both colistin and polymyxin B are available, prospective studies should be conducted to formally examine their relative efficacy and safety in various types of infections and patients. In the meantime, where clinicians have access to both polymyxins, they should carefully consider the relative merits of each in a given circumstance.
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