Revision of Polymyxin B from Aug 13, 2020

Dosing: Adult Antimicrobial Dosing, Non-dialysis

Indication Dosing Note
All Indications 2.5 mg/kg IV x1, then 1.5 mg/kg IV q12h No renal dose adjustment

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication Dosing Note
All Indications 2.5 mg/kg IV x1, then 1.5 mg/kg IV q12h No dose adjustment for hemodialysis

Dialysis Notes

Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.  For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.

There are other more effective, less toxic alternatives for most multidrug-resistant Gram-negative infections.  If a polymyxin is required, polymyxin B is preferred for intravenous treatment of systemic infections in adults. For treatment of urinary tract infections, or use via inhalation, use colistin (polymyxin E).

Restricted to ID or Antimicrobial Stewardship 

ZSFG: Non-formulary

References: