PMBTM

Polymyxin B
Polymyxin Antibiotics (Other Antibiotics)

Indication:
PMBTM (Polymyxin B Sulfate) is indicated for the treatment of patients with the following infections, when caused by susceptible strains of the designated aerobic gram negative bacteria:
• Urinary tract infections caused by Pseudomonas aeruginosa and Escherichia coli
• Bloodstream infections caused by Pseudomonas aeruginosa, Enterobacter (formerly called Aerobacter) aerogenes and Klebsiella pneumonia
• Meningeal infections caused by Pseudomonas aeruginosa
PMBTM (Polymyxin B Sulfate) should be used where sensitivity suggests more commonly used systemic antibacterial agents may be contraindicated or ineffective because of bacterial resistance.

Dosage & Administration:
Method of reconstitution
Intravenous: Dissolve Polymyxin B 500,000 units in 300 to 500 ml solutions for parenteral Dextrose injection 5% for continuous drip.
Intramuscular: Dissolve Polymyxin B 500,000 units in 2 ml 0.9% Sodium Chloride solution. It is not recommended routinely because of severe pain at injection site, particularly in infants and children.
Intrathecal: Dissolve Polymyxin B 500,000 units in 10 ml 0.9% Sodium Chloride solution for 50,000 units per ml dosage unit. In meningeal infections, Polymyxin B Sulfate should be administered only by the intrathecal route.

IV (Intravenous Route):
Adult & Children (Normal kidney function)- 15,000-25,000 (Not exceed 25,000) Units/Kg/Day given in two divided dose (12 hourly) over a period of approximately 60 to 90 minutes.
Adult & Children (Renal impairment)- Less Than 15,000 Units/Kg/Day given in two divided dose (12 hourly) over a period of approximately 60 to 90 minutes.
Infants (Normal Kidney Function)- Maximum 40,000 Units/Kg/Day given in two divided dose (12 hourly) over a period of approximately 60 to 90 minutes.

IM (Intramuscular Route):
Adult & Children- 25,000-30,000 Units/Kg/Day given in 4-6 divided doses
Infants (Normal Kidney Function)- Maximum 40,000 Units/Kg/Day. (Not Recommended due to severe pain at injection site)

Intrathecal Route:
Adults and children over 2 years of age: Dosage is 50,000 units once daily intrathecally for 3 to 4 days, then 50,000 units once every other day for at least 2 weeks after cultures of the cerebrospinal fluid are negative and sugar content has returned to normal.
Children under 2 years of age: 20,000 units once daily, intrathecally for 3 to 4 days or 25,000 units once every other day. Continue with a dose of 25,000 units once every other day for at least 2 weeks after cultures of the cerebrospinal fluid are negative and sugar content has returned to normal.

Preparation:
Each box contains one filled vial of Polymyxin B Sulfate USP equivalent to 5,00,000 Units Polymyxin B accompanied by one 10 ml 0.9% Sodium Chloride ampoule and one 10 ml disposable syringe.



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