Polymyxin B sulfate

Some polymyxins are sold for second-line systemic therapy. Polymyxin B sulfate and colistimethate sodium can be used for intravenous, intramuscular, or intrathecal administration, especially for Pseudomonas aerupinosa mP QXiosis, but also for most other gram-negative organisms, such as those resistant to first-line antibiotics. Nephrotoxicity and various neurotoxicities are common in parenteral, but not in topical, use. Resistance to polymyxins develops slowly, involves mutation and, at least in some bacteria, adaptation, a poorly understood type of resistance that is rapidly lost on transfer to a medium free of polymyxin. Resistance can involve changes in the proteins, the lipopolysaccharides, and lipids of the outer membrane of the cell (52). Polymyxin and colistin show complete cross-resistance. 

Although tyrothricia is too toxic for parenteral therapy, it was formerly sold in the United States as oral lo2enges. Modem tyrothricin formulations are composed of 70—80% tyrocidines and 30—20% linear gramicidins. Tyrocidines are not as active as linear gramicidins and are too toxic for any therapeutic use by themselves. The bactericidal linear gramicidins are used in the United States solely as an ophthalmic solution in combination with polymyxin B sulfate and neomycin sulfate. The linear gramicidin is used in this aqueous product as a substitute for bacitracin, which lacks stabiUty under such conditions. 

Nystatin (100,000 lU) is also available in combination with neomycin sulfate [1405-10-3] (35,000 lU), polymyxin B sulfate [1405-20-5] (35,000 lU), acetarsol [97-44-9] (150 mg), and dimethicone [8050-81-5] (2,500 mg). One or two ovules per day are inserted vaginaHy for at least 6—12 days. This combination has an antibacterial, antimycotic, and antitrichomonas action (see also Antibiotics, oligosaccharides Antiparasitic agents, antiprotozoals). 

AK-Fbly-Bac Ophthalmic Ointment—polymyxin B sulfate, bacitracin zinc... 

Fblytrim Ophthalmic Solution—polymyxin B sulfate, trimethoprim sulfate... 

Otosporia (Warner-Lambert)-comb. Polymyxin B sulfate (Pfizer)... 

United States Pharmacopoeia 28 [1] describes a microbiological method under antibiotics-microbial assays for the analysis of OTC and nystatin capsules, OTC and nystatin for oral suspension, OTC HC1 and hydrocortisone ointment, and OTC HC1 and polymyxin B sulfate ointment. The methods are relative rather than absolute, which are based on the determination of the level of oxytetracycline by a microbiological response to a series of standard oxytetracycline concentrations by a... 

Kang, J. W., Van Schepdael, A., Orwa, J. A., Roets, E., and Hoogmartens, J. (2000). Analysis of polymyxin B sulfate by capillary zone electrophoresis with cyclodextrin as additive. Method development and validation. J. Chromatogr. A 879(2), 211—218. 

Admixture incompatibilities - Magnesium sulfate in solution may result in a precipitate formation when mixed with solutions containing Alcohol (in high concentrations) alkali carbonates and bicarbonates alkali hydroxides arsenates barium calcium clindamycin phosphate heavy metals hydrocortisone sodium succinate phosphates polymyxin B sulfate procaine hydrochloride salicylates strontium tartrates. 

Powder for solution 500,000 units Polymyxin B Sulfate Sterile (Roerig) Rx)... 

Polymyxin B sulfate, a polypeptide antibiotic, is effective against gram-negative organisms. Hypersensitivity to topically applied polymyxin is rare. To reduce the likelihood of neurotoxicity and nephrotoxicity the total daily dose applied to the denuded skin or to open wounds should not exceed 200 mg. 

Various antibiotics bacitracin chloramphenicol colistimethate sodium fosfomycin tromethamine fusidic acid metronidazole polymyxin B sulfate rifabutin sodium fusidate... 

Neomycin sulfate polymyxin b sulfate, pramoxine hcl Neosporin... 

Bacitracin zinc polymyxin B sulfate Polysporin Propylene glycol, sorbitan sesquioleate, and white petrolatum... 

Bacitracin neomycin sulfate, polymyxin B sulfate pramoxine hydrochloride Neosporin plus pain relief Liquid paraffin, microcrystalline wax, propylene glycol... 

Physical and chemical genetic techniques have been used to enhance the permeability of yeast membranes. Permeabilizing agents, such as polymyxin B sulfate and polymyxin B nonapeptide, have been used to physically disrupt the integrity of yeast membranes (14). However, use of such chemical agents in drug screening is not ideal, because of the toxicity induced by polymyxin B treatment. 

Boguslawski, G. (1985) Effects of polymyxin B sulfate and polymyxin B non-apeptide on growth and permeability of the yeast Saccharomyces cerevisiae. Mol. Gen. Genet. 199,401-405. 

Polymyxin B Preparations that are highly acidic or alkaline in nature and other antibacterials are incompatible with polymyxin B sulfate. Polymyxin interacts with neuromuscular blockers and nephrotoxic drugs. 

Heparin and its salts are incompatible with many drugs including alteplase, amikacin sulfate, amiodarone hydrochloride, ampicillin sodium, aprotinin, benzylpenicillin potassium or sodium, cephalothin sodium, ciprofloxacin lactate, cytarabine, dacarbazine, daunorubicin hydrochloride, diazepam, dobutamine hydrochloride, doxorubicin hydrochloride, droperidol, erythromycin lactobionate, gentamicin sulfate, haloperidol lactate, hyaluronidase, hydrocortisone sodium succinate, kanamycin sulfate, methicillin sodium, netilmicin sulfate, some opioid analgesics, oxytetracycline hydrochloride, some phenothiazines, polymyxin B sulfate, streptomycin sulfate, tetracycline hydrochloride, tobramycin sulfate, vancomycin hydrochloride, vinblastine sulfate, cisatracurium besylate, labetalol hydrochloride, nicardipine hydrochloride, cefmetazole, sodium ions, and fat emulsion.110 112... 

Evans ME, Feola DJ, Rapp RP. Polymyxin B sulfate and colistin old antibiotics for emerging multiresistant Gramnegative bacteria. Ann Pharmacother 1999 33(9) 960-7. 

A food additive (flavored BMI-60) may help to mask the bitter taste of polymyxin B sulfate tablets (33). 

Saito M, Hoshi M, Igarashi A, Ogata H, Edo K. The marked inhibition of the bitter taste of polymyxin B sulfate and trimethoprim x sulfamethoxazole by flavored BMI-60 in pediatric patients. Biol Pharm Bull 1999 22(9) 997-8. 

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