Polymyxin B Therapy-Induced Respiratory Arrest in a Liver Donor: A Case Report

Polymyxin B is a potent antibiotic used in multi-drug resistant (MDR) gram-negative infections. It is a known nephrotoxic and neurotoxic drug with serious side effects. Respiratory paralysis is very rarely seen with polymyxin B therapy, with only a few cases reported worldwide. We report a case of a young liver donor who developed respiratory arrest after receiving intravenous (IV) polymyxin B, required intubation, and mechanical ventilatory support. The patient regained full consciousness within an hour. After reviewing literature, we found that polymyxins can cause such side effects. Polymyxin B was discontinued, and she was extubated the following day. With the emergence of MDR organisms, the use of polymyxin B has increased tremendously. This case highlights the importance of closely monitoring patients who are administered such potent antibiotics