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Dose-Related Clinical Efficacy of Polymyxin B in a Critically Ill Patient

Singh, Manisha MBBS; Vilsaint, My-Charllins MD; Quale, John MD

Infectious Diseases in Clinical Practice: March 2013 - Volume 21 - Issue 2 - p 131–132
doi: 10.1097/IPC.0b013e318260221b
Case Reports

Published dosing schemes call for reduced dosage of polymyxin B for patients with renal insufficiency. However, recent evidence suggests that clearance of polymyxin B is not affected by renal function. We report a patient with renal insufficiency who had microbiological failure when adjusted dosing was administered but clearance of bacteremia when the dose was increased to that recommended for a patient with normal renal function.

Even though polymyxins are being used more commonly with the emergence of resistant gram negative bacteria, appropriate dosing of Polymyxin B especially in patients with renal insufficiency remains unknown. This reported case indicates that dosage of polymyxin B adjusted for renal insufficiency may be inadequate.

From the Division of Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, NY.

Correspondence to: Manisha Singh, Division of Infectious Diseases, SUNY-Downstate, 450 Clarkson Ave, Brooklyn, NY 11203. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2013 by Lippincott Williams & Wilkins.