Polymyxin B — Dose Evidence | Peptides Community

Reference only — not a dosing recommendation.

Approved regimen

Approved labeled regimen

Product-, indication-, and jurisdiction-specific — see the monograph

IV: Adults and children: 15,000–25,000 U/kg/day divided q12h. Maximum 25,000 U/kg/day. Note: 1 mg polymyxin B base = 10,000 U.
Intrathecal (P. aeruginosa meningitis): Adults and children >2 y: 50,000 U once daily × 3-4 days, then every other day. Continue for ≥2 weeks after CSF culture-negative. Children <2 y: 20,000 U daily ≤3-4 days.
Topical (ophthalmic): 0.1-0.25% solution (10,000-25,000 U/mL).

Modern recommended dosing (per international consensus guidelines, not per original label)

Loading dose: 2.0-2.5 mg/kg (20,000-25,000 U/kg) IV. Maintenance: 1.25-1.5 mg/kg (12,500-15,000 U/kg) q12h. No dose adjustment for renal impairment (unlike CMS/colistin), but monitor renal function.

Not established

What is not established

Optimal dosing for carbapenem-resistant Acinetobacter baumannii (retrospective data only).
Monotherapy for XDR infections (combination therapy widely recommended).
Duration: no RCT-guided recommendation.

Polymyxin B — monograph dose and administration evidence