Toxicity of polymyxins a systematic review of the evidence from old and recent studies 英文参考文献.docVIP

Available online /content/10/1/R27 Research Open Access Vol 10 No 1 Toxicity of polymyxins: a systematic review of the evidence from old and recent studies Matthew E Falagas1,2,3 and Sofia K Kasiakou1 1Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece 2Department of Medicine, Henry Dunant Hospital, Athens, Greece 3Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA Corresponding author: Matthew E Falagas, matthew.falagas@ Received: 7 Oct 2005 Revisions requested: 3 Jan 2006 Revisions received: 13 Jan 2006 Accepted: 18 Jan 2006 Published: 13 Feb 2006 Critical Care 2006, 10:R27 (doi:10.1186/cc3995) This article is online at: /content/10/1/R27 ? 2006 Falagas and Kasiakou; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background The increasing problem of multidrug-resistant Gram-negative bacteria causing severe infections and the shortage of new antibiotics to combat them has led to the re- evaluation of polymyxins. These antibiotics were discovered from different species of Bacillus polymyxa in 1947; only two of them, polymyxin B and E (colistin), have been used in clinical practice. Their effectiveness in the treatment of infections due to susceptible Gram-negative bacteria, including Pseudomonas Results It was reported in the old literature that the use of polymyxins was associated with considerable toxicity, mainly nephrotoxicity and neurotoxicity, including neuromuscular blockade. However, recent studies showed that the incidence of nephrotoxicity is less common and severe compared to the old studies. In addition, neurotoxic effects of polymyxins are usually mild and resolve after prompt discontinuation of the antibiotics.