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Polymyxin Susceptibility Testing and Interpretive Breakpoints: Recommendations from the United States Committee on
Jason M Pogue1, Ronald N Jones2, John S Bradley3,4
1University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA jmpogue@med.umich.edu.
Abstract:
The polymyxins are important agents for carbapenem-resistant Gram-negative bacilli. The United States Committee on Antimicrobial Susceptibility Testing breakpoint recommendations for colistin and polymyxin B are that isolates of Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae are considered susceptible at MIC values of ≤2 mg/liter. These recommendations are contingent upon dosing and testing strategies that are described in this commentary. Importantly, these recommendations are not applicable to lower respiratory tract infections, for which we recommend no breakpoints. Furthermore, there is no breakpoint recommendation for polymyxin B for lower urinary tract infections.
Insights
Polymyxins are key treatments for carbapenem-resistant Gram-negative bacilli infections. New susceptibility breakpoints for colistin and polymyxin B apply to specific bacteria, but not respiratory or urinary tract infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Polymyxins are crucial for treating infections caused by carbapenem-resistant Gram-negative bacilli.
- Carbapenem-resistant Gram-negative bacilli pose a significant global health threat, necessitating effective therapeutic options.