多黏菌素E和多黏菌素B是从多黏芽孢杆菌培养液中获得的多肽类抗生素，临床用于治疗铜绿假单胞菌，鲍曼不动杆菌和肺炎克雷伯菌等耐药菌感染。多黏菌素E的不良反应为肾毒性和神经系统毒性。其中年龄、给药剂量和联用其他药物是发生肾毒性的风险因素。与抗氧化剂、自由基清除剂和某些对肾脏有保护作用的中药联用，可能降低多黏菌素E的肾毒性并提高疗效。肾功能不全者应用多黏菌素E和多黏菌素B无需调整给药剂量。多黏菌素的新型衍生物肾毒性较低。“,”Polymyxin E and polymyxin B were the polypeptide antibiotic which were obtained from the Bacillus polymyxa medium. They were used to treat the resistant bacterial infection with Pseudomonas aeruginosa,Acinetobacter baumannii and Klebsiella pneumonia. The adverse reactions of polymyxin E were renal toxicity and nervous system toxicity. Age,dose and the combination with other drugs are the risk factors of renal toxicity. Combination with antioxidant,free radical scavenger and some Chinese medicine with protective effect on the kidney may reduce the renal toxicity of polymyxin E and improve the curative effect. Patients with renal insufficiency do not need to adjust the dose when they used polymyxin E and polymyxin B. Novel derivatives of polymyxin had lower renal toxicity.