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Polymyxin use associated with respiratory arrest

Hannah Wunsch1, Vivek K Moitra2, Mona Patel3

  • 1Department of Anesthesiology, Columbia University, New York, NY; Department of Epidemiology, Columbia University, New York, NY.

Chest
|February 9, 2012
PubMed

Insights

Polymyxin B, an antibiotic for gram-negative infections, has seen increased use. Two patients experienced respiratory arrest after polymyxin B infusions, highlighting potential severe side effects.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Polymyxins (B and E) are polypeptide antibiotics effective against gram-negative bacteria.
  • Their use declined due to toxicities and alternatives but has resurged for multidrug-resistant infections.
  • Severe side effects of polymyxins are not well-documented.

Observation:

  • Two cases of respiratory arrest were observed in patients receiving polymyxin B.
  • This occurred in the context of a tenfold institutional increase in polymyxin B usage over 10 years.

Findings:

  • Polymyxin B infusions were the likely cause of respiratory arrest in these patients.
  • This suggests a potential link between increased polymyxin B use and severe adverse events.

Implications:

  • Clinicians should be aware of the potential for severe respiratory toxicity with polymyxin B.
  • Careful patient monitoring is crucial during polymyxin B therapy, especially with rising usage.
  • Further research is needed to fully characterize polymyxin B's safety profile.

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