1. Treatment of Severe Gram-Negative Infections:
- Bacteremia: Used to treat bloodstream infections caused by Gram-negative bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae.
- Meningitis: Administered for the treatment of meningitis caused by susceptible Gram-negative bacteria.
- Urinary Tract Infections (UTIs): Used in severe or complicated UTIs when other antibiotics are not effective.
- Respiratory Tract Infections: Used for treating pneumonia and other severe respiratory infections caused by Gram-negative bacteria, especially in ventilated patients or those with cystic fibrosis.
2. Multidrug-Resistant Infections:
- Carbapenem-Resistant Enterobacteriaceae (CRE): Polymyxin B is one of the few antibiotics effective against CRE, a group of bacteria resistant to nearly all available antibiotics.
- Infections Caused by MDR Pseudomonas aeruginosa: Used when other treatment options are limited due to resistance.
3. Infectious Complications in Critically Ill Patients:
- Used in combination with other antibiotics to treat complex infections in critically ill patients, especially in intensive care units (ICUs) where resistant Gram-negative infections are common.
4. Topical or Local Use (in Some Cases):
- Although more commonly used systemically, Polymyxin B can also be used in topical formulations to treat skin and eye infections caused by Gram-negative bacteria.
Polymyxin B is usually administered intravenously, and treatment is typically reserved for severe infections where other antibiotics are ineffective or inappropriate due to resistance. It can also be administered intrathecally or intraventricularly for meningitis or ventriculitis. Monitoring for nephrotoxicity (kidney damage) and neurotoxicity (nerve damage) is critical, as these are significant potential side effects of Polymyxin B therapy.
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