Polymyxin B Sulfate: Renewed Focus on a Last-Resort Antibiotic for Multidrug-Resistant Infections

Polymyxin B Sulfate is regaining critical importance in the fight against multidrug-resistant Gram-negative infections, particularly those caused by carbapenem-resistant Acinetobacter baumannii (CRAB) and other CR-GNB pathogens. As one of the few remaining effective options, Polymyxin B antibiotic is often used in severe hospital-acquired infections, including ventilator-associated pneumonia and bloodstream infections in ICU patients.

Its efficacy, however, comes with the well-known challenge of nephrotoxicity. To address this, Polymyxin B nephrotoxicity risk and monitoring protocols are now widely adopted. Therapeutic drug monitoring (TDM) is guiding individualized dosing, with emerging consensus on maintaining optimal Cmin (minimum plasma concentration) thresholds. This strategy significantly improves therapeutic outcomes while reducing the incidence of acute kidney injury.

Beyond its systemic use, researchers are exploring Polymyxin B sulfate for endotoxin adsorption cartridge therapy. Early studies and ongoing multicenter randomized controlled trials (RCTs) are evaluating its role in sepsis management, especially for patients with endotoxemia. Cartridge-based hemoperfusion systems containing Polymyxin B show promise in removing circulating endotoxins and improving hemodynamic stability.

Another exciting development lies in pulmonary drug delivery. Inhaled Polymyxin B formulations aim to deliver high local concentrations to the lungs, potentially reducing systemic exposure and side effects. Preclinical and early clinical trials are underway to evaluate safety and efficacy in patients with ventilator-associated or nosocomial pneumonia.

Future directions also include leveraging nanocarrier systems, surface modifications, and co-administration with synergistic antibiotics to enhance bacterial targeting, reduce toxicity, and overcome resistance mechanisms.

As a pharmaceutical-grade Polymyxin B Sulfate supplier, we provide high-purity API tailored for injectable formulations and advanced delivery systems. With rising global demand and active research into safer, more effective use, Polymyxin B is poised to play a central role in next-generation antimicrobial strategies.