Polymyxins and their potential next generation as therapeutic antibiotics
- 1Northern Antibiotics Ltd., Finland
- 2Helsinki University Medical School, Finland
The discovery of polymyxins, highly basic lipodecapeptides, was published independently by three laboratories in 1947. Their clinical use, however, was abandoned in the sixties because of nephrotoxicity and because better-tolerated drugs belonging to other antibiotic classes were discovered. Now polymyxins have resurged as the last-resort drugs against extremely multi-resistant strains, even though their nephrotoxicity forces clinicians to administer them at doses that are lower than those required for optimal efficacy. As their therapeutic windows are very narrow, the use of polymyxins has received lots of justified criticism. To address this criticism, consensus guidelines for the optimal use of polymyxins have just been published. Quite obviously, too, improved polymyxins with increased efficacy and lowered nephrotoxicity would be more than welcome. Over the last few years, more than USD 30 million of public money has been used in programs that aim at the design of novel polymyxin derivatives. This perspective article points out that polymyxins do have potential for further development and that the derivatives already now at hand might offer major advantages over the old polymyxins.
Keywords: Polymyxin B, Colistin, Extremely resistant (XDR), Gram - negative bacteria, Improved polymyxins
Received: 10 May 2019;
Accepted: 09 Jul 2019.
Edited by:Aixin Yan, The University of Hong Kong, Hong Kong
Reviewed by:Yixin Shi, Arizona State University, United States
Jyl S. Matson, University of Toledo, United States
Copyright: © 2019 Vaara. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Martti Vaara, Northern Antibiotics Ltd., Espoo, Finland, email@example.com