Substituting Colistin for Polymyxin B

[Caverject]

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with the national backorder of Polymyxin B, are people switching patients over to Colistin? Is their any documented evidence that it's an even conversion or guidelines how to convert the patient?

 

[Caverject]

any takers?

 

[PharmDstudent]

I spent about an hour searching, and this is all I could come up with:
http://apha.imirus.com/Mpowered/imirus.jsp?volume=pt14&issue=1&page=64
(Place the magnifier on the left side directly above "HIV".)

I hope this helps!

 

[Farmercyst]

My suggestion would be ASHP listserve.

 

[Priapism321]

with the national backorder of Polymyxin B, are people switching patients over to Colistin? Is their any documented evidence that it's an even conversion or guidelines how to convert the patient?

Your question implies that this is a big issue; is your institution really using a substantial amount of polymyxin B? I am assuming you are referring to administering the drug in some sort of aerosolized manner?

If the above is indeed the case, I would pose this question: is there any substantial evidence demonstrating clinical benefit of aerosolized polymyxin therapy that would actually necessitate a sophisticated conversion method? I would actually argue there may be more data on colistin being administered via nebulizer for multi-drug resistant gram negative infections, and just give the normal treatment dose of 150 mg twice daily.

If you are by chance referring to intravenous use of these drugs, is there any difference in antimicrobial coverage between the two. If the answer is no, once again, I would just use the recommended dose for IV colistin, which depends on indication and renal capacity.

I may be missing something here, because ASHP states one cause of the back order is an "increase in demand"......my question is, and maybe you can help me, what is generating this demand (if there is something happening that I am not aware of, I may need to refine my response)? They also state a company has just recently gained approval to manufacture polymyxin B and this may be contributing to the shortage (company behind on production).