Some Clinical Uses of Polypeptides
Preparation | Uses | Comments |
|---|---|---|
Combination treatments | ||
Ointment containing bacitracin plus neomycin, polymyxin B(bacitracin/polymyxin B), or both (neomycin/polymyxin B/bacitracin) | Wound infection | May cause contact dermatitis |
Spray containing neomycin, bacitracin, and polymyxin | Prevention of postoperative wound infections | May cause contact dermatitis |
Polymyxin Bophthalmic ointments and solutions with other antimicrobials (eg, bacitracin/polymyxin B, neomycin/polymyxin B, polymyxin B/trimethoprim) and corticosteroids (eg, neomycin/polymyxin B/hydrocortisone) | Ophthalmic use | Significantly improved rates of early clinical remission (although acute bacterial conjunctivitis is frequently self-limited) |
Otic suspension with neomycin/polymyxin B/hydrocortisone or with colistin, neomycin, and hydrocortisone | Otitis externa (commonly due to Pseudomonas aeruginosa) | Clinically effective, but may be no more effective than 2% acetic acid with hydrocortisone In patients with a tympanostomy tube or known perforation of the tympanic membrane, must use a nonototoxic topical preparation (no aminoglycoside or alcohol) |
Bacitracin | ||
Topical | Eradication of Staphylococcus aureus nasal carriage | Less effective than other treatments May cause contact dermatitis |
Colistin | ||
Aerosolized colistin methane sulfonate (colistimethate sodium [CMS]) | Occasionally hospital-acquired pneumonia caused by multidrug-resistant gram-negative bacilli | Associated with fewer adverse effects (eg, chest tightness, throat irritation, cough) than colistin sulfate |
Aerosolized colistin sulfate | Same as for aerosolized colistin methane sulfonate | May be beneficial for patients with cystic fibrosis or nosocomial pneumonia (ventilator-associated or not) due to multidrug-resistant gram-negative bacteria |
Parenteral CMS | Severe infections due to multidrug-resistant gram-negative bacilli such as P. aeruginosa or Acinetobacter species | Reduced dose in patients with renal insufficiency Not first-line therapy |
Polymyxin B | ||
Solutions | Genitourinary irrigation | — |
Parenteral | Severe infections due to multidrug-resistant gram-negative bacilli such as P. aeruginosa or Acinetobacter species | — |