Poliz-B

Monotherapy or in combination w/ relevant antibiotics for extensively drug-resistant gm -ve bacterial infections w/ limited treatment options eg, susceptible strain of Acinetobacter baumannii, UTI caused by Pseudomonas aeruginosa & E. coli, bloodstream infections caused by Pseudomonas aeruginosa, Enterobacter (formerly called Aerobacter) aerogenes & Klebsiella pneumoniae.

IV Infuse over 1 hr. Loading dose: 20,000-25,000 u/kg (2-2.5 mg/kg). Maintenance dose: 12,500-15,000 u/kg (1.25-1.5 mg/kg) every 12 hr.

Hypersensitivity to polymyxins. Myasthenia gravis.

Not to be used for bacterial infections caused by gm -ve bacteria (Proteus spp, Providencia spp, Morganella spp, Serratia marcescens, Burkholderia spp, Neisseria spp), all gm +ve bacteria & anaerobes; known hypersensitivity to polymyxins. Not to be administered by inhalation. Discontinue treatment if allergic reaction occurs; signs of resp paralysis appear; acute kidney injury develops. Anaphylactoid reactions; cross-reactivity w/ bacitracin; previous hypersensitivity reaction to polymyxins or bacitracin. Clostridium difficile-associated disease (CDAD). Neurological disturbances including neuromuscular blockade (generalised muscle weakness, resp depression or arrest), seizure, circumoral paraesthesia or numbness, vertigo, blurred vision, facial flushing & slurring of speech. Rising blood conc of polymyxin B, albuminuria, cellular casts, diminishing urine output & rising BUN; acute renal failure. Significant deterioration of lung function including apnea, bronchospasm, decreases in vital capacity, forced expiratory vol over 1 sec & max voluntary ventilation. Patients w/ porphyria. Consider management w/ fluids, electrolytes, protein supplementation, antibacterial agent effective against Clostridium difficile, or surgical evaluation if clinically indicated in moderate to severe cases of CDAD. Assess & monitor baseline renal function (albuminuria, cellular casts, BUN, serum creatinine or CrCl) prior to & regularly during therapy. Monitor electrolyte abnormalities eg, hypokalemia, hyponatremia, hypochloremia. Avoid concurrent use of nephrotoxic &/or neuromuscular blocking curariform muscle relaxants & other potential neurotoxic drugs; other nephrotoxic drugs including antimicrobials [particularly bacitracin, aminoglycosides, cephaloridine, cephalothin, amphotericin B, paromomycin, polymyxin E (colistin) & vancomycin]. Pregnancy. Discontinue either breastfeeding or treatment during therapy. Elderly (assess renal function prior to & regularly during therapy).

Nephrotoxicity, neurotoxicity, pain at inj site, urticaria, electrolyte imbalance. Pseudomembranous colitis; bronchoconstriction following nebulized polymyxins, anaphylactoid reactions, rash/pruritus, dermatitis, drug fever; facial paralysis, partial deafness, visual disturbance, vertigo, seizure, neuromuscular weakness & blockade; acute renal failure.

Increased renal toxicity w/ diuretics (eg, ethacrynic acid or furosemide) & other potential nephrotoxic &/or neurotoxic agents (eg, bacitracin, kanamycin, streptomycin, tobramycin, amikacin, cephaloridine, cephalothin, paromomycin, polymyxin E (colistin), neomycin, gentamicin, & vancomycin). Increased serious neurotoxicity w/ non-polarizing muscle relaxants (eg, ether, tubocurarine, gallamine, decamethonium, Na citrate), depolarizing muscle relaxant succinylcholine, & other neurotoxic drugs.

Other Antibiotics

J01XB02 - polymyxin B ; Belongs to the class of polymyxins. Used in the systemic treatment of infections.

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