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已发表论文
多粘菌素治疗耐碳青霉烯类革兰氏阴性菌感染：综述
Authors Li X, Chong W, Mo J, Liu J
Received 9 August 2025
Accepted for publication 19 November 2025
Published 3 December 2025 Volume 2025:18 Pages 6313—6322
DOI https://doi.org/10.2147/IDR.S559556
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Hemant Joshi
Xiangquan Li,1,* Weiwei Chong,2,* Jing Mo,3,* Juan Liu3,4
1Department of Critical Care Medicine, Xuzhou Central Hospital, Southeast University Affiliated Xuzhou Central Hospital, Xuzhou, Jiangsu, 221009, People’s Republic of China; 2Department of Cardiovascular Medicine, Nanjing Pukou People’s Hospital, Liangjiang Hospital Southeast University, Nanjing, Jiangsu, 211800, People’s Republic of China; 3Department of Critical Care Medicine, Nanjing Pukou People’s Hospital, Liangjiang Hospital Southeast University, Nanjing, Jiangsu, 211800, People’s Republic of China; 4Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Juan Liu, Email liujuan198708@163.com
Abstract: Antimicrobial resistance poses a serious threat to human health. Polymyxins, as cyclic polypeptide antibiotics, include polymyxin B (PMB) and polymyxin E. Although they have different metabolic pathways, their antibacterial activities are similar. Polymyxins exert their effects through mechanisms such as disrupting bacterial cell membranes, neutralizing endotoxins, and impairing the respiratory chain. In clinical practice, polymyxins are often used in combination with other drugs to treat infections caused by carbapenem-resistant gram-negative bacteria (CRGNB). No difference in efficacy has been demonstrated between PMB and polymyxin E. An increasing amount of evidence suggests that combination therapy is not superior to monotherapy. The combination of intravenous administration and nebulization can help improve microbial clearance. Compared with other antibiotics, polymyxins have not shown obvious survival benefit. Polymyxins are associated with nephrotoxicity and neurotoxicity, and it is essential to closely monitor for related adverse events during the course of treatment.
Keywords: polymyxins, carbapenem-resistant gram-negative bacteria, hospital-acquired pneumonia, bloodstream infections, mortality
1Department of Critical Care Medicine, Xuzhou Central Hospital, Southeast University Affiliated Xuzhou Central Hospital, Xuzhou, Jiangsu, 221009, People’s Republic of China; 2Department of Cardiovascular Medicine, Nanjing Pukou People’s Hospital, Liangjiang Hospital Southeast University, Nanjing, Jiangsu, 211800, People’s Republic of China; 3Department of Critical Care Medicine, Nanjing Pukou People’s Hospital, Liangjiang Hospital Southeast University, Nanjing, Jiangsu, 211800, People’s Republic of China; 4Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Juan Liu, Email liujuan198708@163.com
Abstract: Antimicrobial resistance poses a serious threat to human health. Polymyxins, as cyclic polypeptide antibiotics, include polymyxin B (PMB) and polymyxin E. Although they have different metabolic pathways, their antibacterial activities are similar. Polymyxins exert their effects through mechanisms such as disrupting bacterial cell membranes, neutralizing endotoxins, and impairing the respiratory chain. In clinical practice, polymyxins are often used in combination with other drugs to treat infections caused by carbapenem-resistant gram-negative bacteria (CRGNB). No difference in efficacy has been demonstrated between PMB and polymyxin E. An increasing amount of evidence suggests that combination therapy is not superior to monotherapy. The combination of intravenous administration and nebulization can help improve microbial clearance. Compared with other antibiotics, polymyxins have not shown obvious survival benefit. Polymyxins are associated with nephrotoxicity and neurotoxicity, and it is essential to closely monitor for related adverse events during the course of treatment.
Keywords: polymyxins, carbapenem-resistant gram-negative bacteria, hospital-acquired pneumonia, bloodstream infections, mortality