Colistin is effective against Gram-negative organisms particularly Pseudomonas aeruginosa. It is sometimes used for bowel decontamination in neutropenic patients and topically is applied to skin, including external ear infections. It is occasionally used syste-mically for severe infections with multiply resistant Gram-negative pathogens such as pseudomonads when no alternative agents are available. Adverse effects of systemic administration include nephrotoxicity, neurological symptoms and neuromuscular blockade.
Polymyxin B is also active against Gram-negative organisms, particularly Pseudomonas aeruginosa. Its principal use now is topical application for skin, eye and external ear infections.
Gramicidin is used in various topical applications as eye- and ear-drops, combined with neomycin and framycetin.
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