Endobronchial Polymyxin B: Experimental Observations in Chronic Bronchitis

Abstract

Observations in three patients have shown that endobronchial administration of polymyxin B in 10 ml of saline through a transtracheal catheter achieves a wide bronchopulmonary distribution. The antibiotic was well tolerated when administered three times daily in doses of 300 μg to 1.0 mg. Concentrations of the antimicrobial reaching levels of 1.8 to 3.1 μg ml of expectorated sputum were achieved without adverse effects in a patient continuously for seven weeks with 1 mg of polymyxin B. Therapeutic concentrations of the drug in the sputum were maintained as long as 12 hours after endobronchial administration. The effectiveness of this technique in suppressing a chronic life-threatening bronchial infection with Pseudomonas aeruginosa is documented. The endobronchial approach in the treatment of chronic bronchitis is discussed.