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Polymyxin Use Associated With Respiratory ArrestPolymyxin and Respiratory Arrest

Hannah Wunsch, MD; Vivek K Moitra, MD; Mona Patel, PharmD; Amy L. Dzierba, PharmD
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From the Department of Anesthesiology (Drs Wunsch and Moitra) and the Department of Epidemiology (Dr Wunsch), Columbia University; and the Department of Pharmacy (Drs Patel and Dzierba), New York-Presbyterian Hospital, New York, NY.

Correspondence to: Hannah Wunsch, MD, Department of Anesthesiology, Columbia University, 622 W 168th St, PH5-527D, New York, NY 10032; e-mail: hw2125@columbia.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(2):515-517. doi:10.1378/chest.11-1483
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The polymyxins (polymyxin B and E) are bactericidal polypeptide antibiotics first discovered in 1947 and used for the treatment of gram-negative bacterial infections. Renal and neurologic toxicities coupled with the increasing availability of effective alternatives led to declining use in the 1960s. The emergence of multidrug-resistant organisms in the past decade has resulted in a resurgence in the use of polymyxins in critically ill patients, yet the side effects are not well known. We report two cases of respiratory arrest likely due to polymyxin B infusions in the context of a 10-fold increase in the use of polymyxin B in our institution over the past 10 years.

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