• Vol. 37 No. 10, 870–883
  • 15 October 2008

Polymyxins: A Review of the Current Status Including Recent Developments



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Introduction: Polymyxins have become the drug of choice for treatment of multidrug-resistant gram-negative bacilli infections in Singapore, simply because these pathogens are only susceptible to either aminoglycosides and polymyxins, or polymyxins only. Furthermore, there is no new antibiotic in the pipeline that targets these difficult-to-treat infections.

Materials and Methods: All published literatures (up to end of February 2008) regarding polymyxins are included for review.

Results: This review serves to give a summary of polymyxins from the current available literature, highlighting relevant clinical studies and information that help to guide informed prescription of polymyxins, should the need arise.

Conclusions: However, there are substantial information gaps that needed to be filled urgently, to preserve the clinical utility of this very last line of antibiotic.

Polymyxins are polypeptide antibiotic that becomes available for clinical use in the 1960s, but was replaced in the 1970s by antibiotics considered less toxic. Presently, polymyxins have re-emerged as a “no choice” alternative for treatment of multidrug-resistant (MDR) gram-negative bacilli infections, which are not infrequent, in Singapore and Asia Pacific regions.

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