SynthesisCritical care (London, England)2006
Toxicity of polymyxins: a systematic review of the evidence from old and recent studies.
Synthesis in Critical care (London, England), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 316 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
316 citing papers in PubMed, 790 citations in OpenAlex.
- Phase 1 study of the safety, tolerability, and pharmacokinetics of a synthetic macrocyclic peptide antibiotic (BRII-693) in healthy adult participants.Antimicrobial agents and chemotherapy · 2025Trial
- Pharmacokinetics and safety of EVER206, a novel polymyxin antimicrobial, in healthy Chinese subjects.Antimicrobial agents and chemotherapy · 2024Trial
- Single- and Multiple-Ascending-Dose Study of the Safety, Tolerability, and Pharmacokinetics of the Polymyxin Derivative SPR206.Antimicrobial agents and chemotherapy · 2021Trial
- Multicenter Population Pharmacokinetic Study of Colistimethate Sodium and Colistin Dosed as in Normal Renal Function in Patients on Continuous Renal Replacement Therapy.Antimicrobial agents and chemotherapy · 2019Trial
- Comparative Genomics of Paenibacillus Secondary Metabolism: Unveiling the Putative Biosynthetic Gene Cluster for Paenialvins in Paenibacillus Alvei Strain 32.Probiotics and antimicrobial proteins · 2026Article
- Systems-Level Phosphoproteomic and RPPA Profiling Reveals Stress and DNA Damage Signalling as Early Drivers of Polymyxin B Neurotoxicity.Molecular neurobiology · 2026Article
- Transient paresthesia following polymyxin B loading dose in a critically ill patient: a case report.Annals of medicine and surgery (2012) · 2026Article
- Polymyxin B-associated hearing impairment in a patient with renal dysfunction- a case report.BMC nephrology · 2026Article
- Bacterial extracellular vesicles promote membrane repair and tolerance to polymyxin B.Science advances · 2026Article
- Development and application of a simple LC-MS/MS method for therapeutic drug monitoring to guide colistin dosing in critically Ill patients.BMC pharmacology & toxicology · 2026Article
- Zwitterionic Mn(III)-Tetraphenyl Porphyrins: Water-Soluble MRI Contrast Agents with High Relaxivity.ChemMedChem · 2026Article
- Antibiotic Mechanisms and Resistance: Molecular Insights and Therapeutic Strategies.Antibiotics (Basel, Switzerland) · 2026Review
- Selectivity Modulation of Small Cationic Membrane-Active Cyclic Peptides with Broad-Spectrum Activity against Bacteria and Fungi.Journal of medicinal chemistry · 2026Article
- The pharmacodynamics of polymyxin B in Acinetobacter baumannii in murine thigh and lung infection models.The Journal of antimicrobial chemotherapy · 2026Article
- A rare drug reaction: Toxic epidermal necrolysis following polymyxin B administration in a post-Bentall procedure.Indian journal of pharmacology · 2026Article
- Lipopeptide Engineering: From Natural Origins to Rational Design Against Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2026Review
- From Initiation to Recovery: A Longitudinal Analysis of Polymyxin B-Induced Kidney Injury in Clinical Practice.Drug design, development and therapy · 2026Article
- Polymyxin B-induced acute kidney injury in a burn patient: a case report and pharmaceutical care.Frontiers in medicine · 2026Article
- Safety and Efficacy of Nebulized Inhalation of Polymyxin B Sulfate for Carbapenem-Resistant Gram-Negative Bacterial Pneumonia: A Multi-Center, Prospective, Observational Study.Infection and drug resistance · 2026Article
- Polymyxin-Associated Neurotoxicity: A Case of Guillain-Barré Syndrome Temporally Linked to Colistin Methanesulfonate and Respiratory Paralysis with Polymyxin B.Infection and drug resistance · 2026Article
256 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 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 aeruginosa and Acinetobacter baumannii, has not been generally questioned. However, their use was abandoned, except in patients with cystic fibrosis, because of concerns related to toxicity.
methodsWe reviewed old and recent evidence regarding polymyxin-induced toxicity by searching Pubmed (from 1950 until May 2005).
resultsIt 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. Furthermore, cases of neuromuscular blockade and apnea have not been reported in the recent literature.
conclusionNew evidence shows that polymyxins have less toxicity than previously reported. The avoidance of concurrent administration of nephrotoxic and/or neurotoxic drugs, careful dosing, as well as more meticulous management of fluid and electrolyte abnormalities and use of critical care services may be some of the reasons for the discrepancy between data reported in the old and recent literature.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.