Agents of Last Resort: Polymyxin Resistance

Keith S Kaye; Jason M Pogue; Thien B Tran; Roger L Nation; Jian Li

doi:10.1016/j.idc.2016.02.005

Agents of Last Resort: Polymyxin Resistance

Infect Dis Clin North Am. 2016 Jun;30(2):391-414. doi: 10.1016/j.idc.2016.02.005.

Authors

Keith S Kaye¹, Jason M Pogue², Thien B Tran³, Roger L Nation³, Jian Li³

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Detroit Medical Center, Wayne State University, 3990 John R, Detroit, MI 48201, USA. Electronic address: kkaye@dmc.org.
² Department of Pharmacy Services, Sinai-Grace Hospital, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA.
³ Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Australia.

PMID: 27208765
DOI: 10.1016/j.idc.2016.02.005

Abstract

Polymyxin resistance is a major public health threat, as the polymyxins represent "last-line" therapeutics for Gram-negative pathogens resistant to essentially all other antibiotics. Improved understanding of mechanisms of, and risk factors for, polymyxin resistance, as well as infection prevention and stewardship strategies, together with optimization of dosing of polymyxins including in combination regimens, can help to limit the emergence and dissemination of polymyxin resistance.

Keywords: Colistin; Gram-negative; Polymyxin B; Polymyxins; Resistance.

Publication types

Review

MeSH terms

Drug Resistance, Multiple, Bacterial*
Gram-Negative Bacteria* / drug effects
Gram-Negative Bacteria* / pathogenicity
Gram-Negative Bacterial Infections* / drug therapy
Gram-Negative Bacterial Infections* / microbiology
Humans
Polymyxins*
Public Health

Substances

Polymyxins