Polymyxin B (Polymyxinum B)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Other antibiotics

Included in the formulation
  • Vellobactin-B®
    lyophilizate for injections 
    KORAL-MED, CJSC     Russia
  • Wilimixin®
    powder w / m in / in 
    PREBAND PFC, LLC     Russia
  • Polymyxin B
    lyophilizate for injections 
    JODAS EKSPOIM, LLC     Russia
  • Subvixin
    powder for injections 
    KRASFARMA, JSC     Russia
    • АТХ:

    J.01.X.B.02   Polymyxin B

    Pharmacodynamics:

    The drug blocks the permeability of the cytoplasmic membrane of bacteria, which leads to their destruction. The drug is active against mainly Gram-negative bacteria: Escherichia coli, Enterobacter spp., Klebsiella spp., Haemophilus influenzae, Bordetella pertussis, Salmonella spp., Shigella spp., Pseudomonas aeruginosa, Vibrio cholerae (Besides Vibrio cholerae eltor), Coccidioides immitis.

    Pharmacokinetics:

    After intramuscular injection, the maximum concentration in blood plasma is achieved after 2 hours. Widely distributed in the organs and tissues of the body. When you re-enter it is possible to accumulate. Does not penetrate the blood-brain barrier. The half-life is 6 hours, excreted by the kidneys.

    Indications:

    Infectious-inflammatory diseases, which are caused by microorganisms sensitive to the preparation.

    Acute infections caused by sensitive microorganisms (Pseudomonas aeruginosa, salmonella, shigella, etc.): inside - infectious and inflammatory diseases GITinjections - sepsis, bacteremia, meningitis, pneumonia, externally (or in the cavity) - diseases of the urinary tract (cystitis, urethritis), ENT organs (otitis media, sinusitis, sinusitis), skin (including infected burns, abscess, phlegmon, decubitus), bones (osteomyelitis), eye (conjunctivitis, keratitis).

    ICD-10

    I.A00-A09.A09   Diarrhea and gastroenteritis of allegedly infectious origin

    I.A30-A49.A41.9   Septicemia, unspecified

    I.B99   Other infectious diseases

    VI.G00-G09.G00   Bacterial meningitis, not elsewhere classified

    VII.H00-H06.H01.0   Blepharitis

    VII.H10-H13.H10.2   Other acute conjunctivitis

    VII.H10-H13.H10.4   Chronic conjunctivitis

    VII.H10-H13.H10.5   Blepharoconjunctivitis

    VII.H10-H13.H10.9   Conjunctivitis, unspecified

    VII.H15-H22.H16   Keratite

    VIII.H65-H75.H66   Purulent and unspecified otitis media

    X.J10-J18.J18   Pneumonia without clarification of the pathogen

    X.J30-J39.J32   Chronic Sinusitis

    XI.K80-K87.K81.0   Acute cholecystitis

    XI.K80-K87.K81.1   Chronic cholecystitis

    XI.K80-K87.K83.0   Cholangitis

    XII.L00-L08.L01   Impetigo

    XII.L00-L08.L02   Abscess of skin, boil and carbuncle

    XII.L00-L08.L03   Phlegmon

    XII.L00-L08.L08.0   Pyoderma

    XII.L80-L99.L89   Decubital ulcer

    XIII.M86-M90.M86   Osteomyelitis

    XIV.N30-N39.N30   Cystitis

    XIV.N30-N39.N34   Urethritis and urethral syndrome

    Contraindications:
    • Perforation of the tympanic membrane
    • Hypersensitivity
    • Extensive skin lesions
    • Renal impairment
    • Myasthenia gravis
    Carefully:

    Kidney disease, including chronic renal failure.

    Violations of the nervous system (neurotoxicity), the risk of which is higher in patients with chronic renal failure and / or with other drugs with neurotoxic and / or nephrotoxic properties.

    Diseases that are accompanied by a breakdown of neuromuscular transmission

    Skin lesions of an allergic nature.

    It should avoid simultaneous application of the drug with other neurotoxic and nephrotoxic drugs.

    Pregnancy and lactation:

    Category FDA not determined. Application in pregnancy is not desirable. Pregnant women are prescribed for vital signs, taking into account the expected benefit to the mother and the potential risk to the fetus. The drug penetrates into breast milk, do not take during breastfeeding.

    Dosing and Administration:

    Intramuscularly, intravenously. Adults: intramuscularly - 0,5-0,7 mg / kg 3-4 times a day (the maximum daily dose is not more than 200 mg), intravenously - daily dose of 2 mg / kg in 2 divided doses with an interval of 12 hours (not more than 150 mg). For children: intramuscularly, intravenously regardless of age - 0.3-0.6 mg / kg 3-4 times a day. If the renal function is impaired, the dose decreases, and the intervals between administrations increase in accordance with clearance creatinine.

    Inside (in the form of an aqueous solution). Adults appoint 100 mg every 6 hours, children - 4 mg / kg 3 times a day. The duration of the course is 5-7 days.

    Outwardly. Each hour for 1-3 drops of 0.1-0.25% solution in each eye (in the presence of a positive reaction, the intervals between administrations are increased).

    Intrathecal. Adults and children over 2 years old - 50 000 YE 1 time per day for 3-4 days, then - every other day for 2 more weeks after receiving positive results; Children under 2 years - 20 000 YE per day for 3-4 days or 25 000 YE 1 time in 2 days.

    Side effects:

    From the side nervous system: paresthesia, dizziness, ataxia, drowsiness, respiratory paralysis, peripheral paresthesia, visual impairment, impaired consciousness, in predisposed patients - neuromuscular blockade, respiratory paralysis, apnea; with intrathecal injection - meningeal symptoms.

    From the side urinary system: hematuria, tubular necrosis, impaired renal excretory function (albuminuria, cylindruria, azotemia, proteinemia, tubular necrosis, electrolyte exchange disturbances).

    Superinfection, candidiasis, allergic reactions (skin rash, itching, urticaria, eosinophilia); when ingested - nausea, pain in the epigastric region, decreased appetite; when introduced intramuscularly - soreness at the injection site, intravenous - Thrombophlebitis.

    Overdose:

    Symptoms: respiratory arrest, paralysis of the respiratory musculature, ototoxicity, nephrotoxicity.

    Treatment: artificial ventilation.

    Interaction:

    Miorelaxants and other medicines that block neuromuscular transmission - stopping breathing.

    In solutions it is incompatible with the sodium salt of ampicillin, levomycetin, antibiotics of the cephalosporin group, tetracycline, isotonic sodium chloride solution, amino acid solutions, heparin.

    It shows synergy with chloramphenicol, tetracycline, sulfonamides and trimethoprim with respect to Pseudomonas aeruginosa, Proteus, Serratia, with ampicillin - on the effect on gram-negative rods, carbenicillin - Pseudomonas aeruginosa. We combine with bacitracin and nystatin. It enhances the oto- and nephrotoxicity of aminoglycosides (kanamycin, streptomycin, tobromine, neomycin, gentamicin) and the muscle relaxation caused by them, as well as neuromuscular blockers. Reduces the concentration of heparin in the blood (forms complexes).

    Amphotericin B, cephalothin, other agents with nephrotoxic properties - increased nephrotoxicity.

    Special instructions:

    Parenteral use only in a hospital.

    Systemic use is not recommended.

    At the time of taking the drug, it is necessary to monitor the kidney function, the neurologist's observation.

    Impact on the ability to drive vehicles and manage mechanisms not found.

    Instructions
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