EFFECT OF ORAL POLYMYXIN B ON PSEUDOMONAS AERUGINOSA IN THE GASTROINTESTINAL TRACT

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Abstract
Polymxin B was used to treat 24 ambulatory, asymptomatic and symptomatic individuals found to have Pseudomonas aeruginosa in the gastrointestinal tract. In the control group of 8 asymptomatic carriers, about half of the cases were spontaneously free of the organism in the follow-up studies 25 and 30 days later. The drug was given orally (150 mg./ 8 hrs. for 7 days) to the exptl. group. After 5 days, all the stools were negative for Pseudomonas. In 23 cases stool cultures were repeated 25 and 30 days after the drug had been started. At this time, all were negative for Pseudomonas except 1. About half of the subjects receiving the drug had mild adbominal cramps or mild diarrhea or both between the 1st and 3d days of drug admn., and these lasted from a few hrs. to 2 days. They disappeared in each instance in spite of continuation of therapy and without admn. of other drugs. Polymyxin B should be considered promptly as one of the control measures in any outbreak of diarrhea in a nursery of newborn babies where Pseudomonas is found as the most likely pathogen. Its prophylactic use may also be considered when personnel are found to harbor this organism. Oral polymyxin B is very effective in eliminating P. aeruginosa when it is present in the gastrointestinal tract either in carriers or in active infections. The literature on Pseudomonas infections is reviewed.