Polymyxin B-induced gastric spasm:a case report
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By
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Chuan Sun
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Yao Sun
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Dandan Yang
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Tianjiao Hu
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Lihua Yuan
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June 22, 2026
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Clinical Scorecard: Gastric Spasm Associated with Polymyxin B: A Case Study
At a Glance
| Category | Detail |
|---|
| Condition | Gastric Spasm |
| Key Mechanisms | Polymyxin B elevates histamine levels, enhancing gastric acid secretion and triggering an inflammatory response. |
| Target Population | Children with carbapenem-resistant Acinetobacter baumannii infections |
| Care Setting | Clinical treatment of surgical site infections |
Key Highlights
- Polymyxin B can induce gastric spasm as an adverse drug reaction.
- A 14-year-old boy experienced severe abdominal colic after polymyxin B infusion.
- Discontinuation of polymyxin B led to significant symptom improvement.
- CT scan showed gastric wall thickening associated with the reaction.
- Naranjo algorithm score of +6 indicates a probable causal link.
Guideline-Based Recommendations
Diagnosis
- Monitor for adverse drug reactions in patients receiving polymyxin B.
Management
- Discontinue polymyxin B if gastric spasm symptoms occur.
Monitoring & Follow-up
- Assess for gastrointestinal symptoms during polymyxin B treatment.
Risks
- Potential for nephrotoxicity, neurotoxicity, and hypersensitivity reactions.
Patient & Prescribing Data
Children undergoing treatment for carbapenem-resistant Acinetobacter baumannii infections.
Combination therapy with meropenem and polymyxin B requires careful monitoring for adverse effects.
Clinical Best Practices
- Utilize the Naranjo algorithm for assessing causality of adverse drug reactions.
- Implement individualized treatment regimens based on patient-specific conditions.
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