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Antimicrobial Agents and Chemotherapy, August 2003, p. 2659-2662, Vol. 47, No. 8
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.8.2659-2662.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Polymyxin B Nephrotoxicity and Efficacy against Nosocomial Infections Caused by Multiresistant Gram-Negative Bacteria

John P. Ouderkirk,{dagger} Jill A. Nord,* Glenn S. Turett, and Jay Ward Kislak

Section of Infectious Diseases, Department of Medicine, Saint Vincent's Hospital—Manhattan, New York, New York 10011

Received 10 January 2003/ Returned for modification 28 February 2003/ Accepted 28 April 2003

Reported rates of nephrotoxicity associated with the systemic use of polymyxins have varied widely. The emergence of infections due to multiresistant gram-negative bacteria has necessitated the use of systemic polymyxin B once again for the treatment of such infections. We retrospectively investigated the rate of nephrotoxicity in patients receiving polymyxin B parenterally for the treatment of infections caused by multiresistant gram-negative bacteria from October 1999 to September 2000. Demographic and clinical information was obtained for 60 patients. Outcome measures of interest were renal toxicity and clinical and microbiologic efficacy. Renal failure developed in 14% of the patients, all of whom had normal baseline renal function. Development of renal failure was independent of the daily and cumulative doses of polymyxin B and the length of treatment but was significantly associated with older age (76 versus 59 years, P = 0.02). The overall mortality was 20%, but it increased to 57% in those who developed renal failure. The organism was cleared in 88% of the patients from whom repeat specimens were obtained. The use of polymyxin B to treat multiresistant gram-negative infections was highly effective and associated with a lower rate of nephrotoxicity than previously described.

* Corresponding author. Mailing address: Section of Infectious Diseases, Department of Medicine, Saint Vincent's Hospital—Manhattan, 153 W. 11th St., Cronin Building, Room 1003, New York, NY 10011. Phone: (212) 604-2116. Fax: (212) 604-2738. E-mail: jillanord{at}aol.com.

{dagger} Present address: ID Group of Atlanta, Atlanta, GA 30313.

Antimicrobial Agents and Chemotherapy, August 2003, p. 2659-2662, Vol. 47, No. 8
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.8.2659-2662.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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