多黏菌素B应用研究进展

Advance in the Application of Polymyxin B

多黏菌素B(PMB)具有杀菌与中和内毒素活性双重功效。近年来,医院感染的多重耐药革兰阴性菌日益增多,使得PMB重新受到重视。由于无法确定单独使用或联合用药时PMB的药物代谢学、药效学和毒效学等参数,PMB的最佳剂量仍无法确定。PMB在去除内毒素方面的应用主要是利用多黏菌素B固定化纤维柱(PXB),通过血液灌流过滤法在体外治疗脓毒血症和休克反应,已经取得良好效果,但由于研究分析存在缺乏空白对照等问题,仍需对PXB进行细致的研究,从而使其广泛应用到易受内毒素污染的化学药品和生物制品的生产中去。

Polymyxin B（PMB） has both abilities of antibacteri and antiendotoxin.Since antibacterial action was played through the interaction of PMB and LPS in cell wall,PMB have re-emerged in clinical practice owing to the increasing prevalence of nosocomial infections caused by multidrug-resistant Gram-negative bacteria.However,the pharmacokinetics,pharmacodynamics and toxicodynamics of polymyxin B and its efficacy alone and in combination with other antibiotics are not defined.Thus,optimized dosage regimens are not known yet.Direct hemoperfusion using The polymyxin B immobilized fiber column（PXB）,which was applied to the treatment of sepsis and shock to removal endotoxin,has showed good results.But many of the analyzed studies were of suboptimal quality such as lacking of control group.The PXB needs to be detail studied,and can be used to remove ednotoxin in the production of chemicals and biological products which were susceptible to endotoxic contamination.