The Renaissance of Polymyxins
B. Kadar, B. Kocsis, K. Nagy and D. Szabo
Affiliation: Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary.
Polymyxins are polypeptide antibiotics, with a primary effect of membrane damaging due to their selective
binding to the lipopolysaccharide of Gram-negative bacteria. Their nephro- and neurotoxic side effects limited their use,
however, in the last decade the emergence of multidrug-resistant Gram-negative bacteria led to the reintroduction of polymyxins
into clinical practice. This review provides an overview about the history and the latest developments of polymyxins.
We describe the antimicrobial effects, pharmacodynamics, pharmacokinetics and different routes of administration.
We highlight natural classic polymyxins, namely polymyxin B and E, the non-classic agents polymyxin M, S and T.
Novel polymyxin chemical structure derivatives will be listed including NAB739, NAB740, NAB741 and NAB7061, that
can have important therapeutical role in the future.
Keywords: Antimicrobial activity, colistin, mechanism of action, polymyxin B, polymyxin derivatives, structure-activity relationship,
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