With the advent of potent broad-spectrum antibiotics, such as the quinolones and third-generation cephalo-sporins, the indications for the use of the polymyxins, with their serious potential for toxicity, are few. Their only justifiable use may be as topical agents.
In combination with neomycin, polymyxin B can be used as a bladder irrigant to reduce the risk of catheter-associated infections, although this use remains controversial. It also can be used as topical therapy in external otitis caused by P. aeruginosa.
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