R

Figure 2-6. Polymixins.

nucleosides, and other small molecules. In addition to having both hydrophilic (peptide) and hydrophobic (alkane) groups, these drugs also have cationic surface-active properties (see later). The antibacterial effects are therefore neutralized by anionic detergents such as soaps.

Polymixins are not orally absorbed. Thus systemic infections by sensitive organisms are treated by intramuscular injections or intrathecally (e.g., spinal meningitis). Toxicities are primarily to the kidneys and transient neurological disturbances, including neuromuscular blockade. Oral use (colistin) is limited to bacterially induced diarrhea. External applications of lotions, ointment, and drops are useful in the treatment of eye and ear infections, as well as burns and other wounds.

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