Polymyxin B

Anaphylactoid reactions with dyspnea and tachycardia

Eosinophilia

Fever

Nephrotoxicity

Neurotoxicity

Skin exanthemata

Urticaria

Caution in oliguria, myasthenia gravis, pregnancy, renal disease

Potential risk of nephrotoxicity and neurotoxicity

May inhibit neuromuscular transmission

Inactivated by strong acidic or alkaline solution

Clostridium difficile-associated diarrhea (CDAD) has reported; may range in severity from mild diarrhea to fatal colitis; if CDAD suspected or confirmed ongoing, antibiotic use not directed at C. Difficile may need to be discontinued

Prescribing polymyxin B in absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases risk of development of drug-resistant bacteria

Baseline renal function should be done prior to therapy, with frequent monitoring of renal function and blood levels of the drug during parenteral therapy; discontinue if diminished urine output, rise in SCr or BUN, or signs of respiratory paralysis appear

Do not use IM routinely, particularly in peds, because of severe inj site pain

Avoid concurrent use of a curaiform muscle relaxant and other neurotoxic drugs which may precipitate respiratory depression; if signs of respiratory paralysis appear, respiration should be assisted as required, and drug discontinued

As with other antibiotics, use may result in overgrowth of nonsusceptible organisms, including fungi; if superinfection occurs, appropriate therapy should be instituted