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Review
. 2019 Mar 22;8(1):31.
doi: 10.3390/antibiotics8010031.

A Review of the Clinical Pharmacokinetics of Polymyxin B

Sean N Avedissian  1   2   3 , Jiajun Liu  4   5   6 , Nathaniel J Rhodes  7   8   9 , Andrew Lee  10 , Gwendolyn M Pais  11   12 , Alan R Hauser  13 , Marc H Scheetz  14   15   16   17
Affiliations
Review

A Review of the Clinical Pharmacokinetics of Polymyxin B

Sean N Avedissian et al. Antibiotics (Basel). .

Abstract

Polymyxin B remains an antibiotic of last resort because of its toxicities. Although newer therapies are becoming available, it is anticipated that resistance to these agents will continue to emerge, and understanding the safest and most efficacious manner to deliver polymyxin B will remain highly important. Recent data have demonstrated that polymyxin B may be less nephrotoxic than colistin. Pharmacokinetically, polymyxin B is primarily eliminated via non-renal pathways, and most do not recommend adjusting the dose for renal impairment. However, some recent studies suggest a weak relationship between polymyxin B clearance and patient creatinine clearance. This review article will describe the clinical pharmacokinetics of polymyxin B and address relevant issues in chemistry and assays available.

Keywords: pharmacokinetics; polymyxin B.

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Conflict of interest statement

Authors declare no relevant conflict of interest.

Figures

Figure 1
Figure 1
Stereochemical formula (A) and general molecular structure (B) of polymyxin B. Abbreviations: Fatty acid = 6-methyloctanoic acid for polymyxin B1, 6-methylheptanoic acid for B2, octanoic acid for B3, and heptanoic acid for B4, Dab = diaminobutyric acid, Thr = threonine, Phe = phenylalanine, Leu = leucine.
See this image and copyright information in PMC

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