Abstract
Spread of multiresistant bacteria makes us to reconsider our attitude to some well-known old antimicrobials, including polymyxins – a class of polypeptide antibiotics that are active against many multiresistant gram-negative nosocomial pathogens – Escherichia coli, Klebsiella spp., Enterobacter spp., Salmonella spp., Shigella spp., Haemophilus influenzae, Brucella spp., Pseudomonas aeruginosa, Acinetobacter spp., etc. At the same time Proteus spp., Serratia marcescens, gram-positive bacteria and many anaerobes, in particular Bacteroides fragilis are resistant to polymyxins. Only 2 polymyxins are used in clinical practice – polymyxin B and colistin (polymyxin Е) that can be used only as «deep alternative» antibiotics for treatment of multiresistant gram-negative infections, in particular infections caused by Pseudomonas spp. and Acinetobacter spp. Literature review on clinical experience are also presented in the article.
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