A Comparison of Adjusted Versus Unadjusted Doses of Polymyxin B Based on Renal Function and Incidence of Acute Kidney Injury

Peyko, Vincent; Cohen, Henry

doi:10.1177/0897190018798881

Cited by 8 publications

(6 citation statements)

References 37 publications

(54 reference statements)

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“…These results caused some confusion, so we reanalyzed the data and found that there was no statistically significant difference in the incidence of neurotoxicity (p = 0.386) and mortality (p = 0.206) between the two groups. The following research by Peyko et al (Peyko and Cohen, 2020) also supported this conclusion. They found that there was no difference between the two groups in the incidence of acute kidney injury at day 7, occurrence of microbiological cure, clinical cure, and 30-days mortality (Table 1, Entry 9).…”

Section: What Are Recent Recommendations In the Latest Research?mentioning

confidence: 57%

Polymyxin B in Patients With Renal Impairment: Is It Necessary to Adjust Dose?

Nie

Wang

et al. 2022

Front. Pharmacol.

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Section: What Are Recent Recommendations In the Latest Research?mentioning

confidence: 57%

Polymyxin B in Patients With Renal Impairment: Is It Necessary to Adjust Dose?

Nie

Wang

et al. 2022

Front. Pharmacol.

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“…This process may explain how polymyxin B causes damage to the kidney when it is cleared as a nonrenal drug. Previous studies reported that the incidence of polymyxin B-induced nephrotoxicity ranged from 18.2% to 46.1% [18,19]. However, different definitions of nephrotoxicity were applied, and a broad polymyxin B dose was administered, which may explain the different results in previous studies.…”

Section: Discussionmentioning

confidence: 98%

Efficacy and nephrotoxicity of polymyxin B in elderly patients with carbapenem resistant bacterial infection

Xia,

Xu,

You

et al. 2023

Ann Clin Microbiol Antimicrob

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Background To study the efficacy and nephrotoxicity of polymyxin B in the treatment of elderly patients with carbapenem-resistant organism (CRO) infection. Methods The clinical and microbiological data of patients with CRO-infected sepsis treated with polymyxin B were retrospectively analyzed. The effective rate, bacterial clearance, incidence and recovery rate of acute renal injury (AKI) and prognosis-related indicators in AKI at different stages were compared. Results The effective rate of 215 elderly patients with CRO infection treated with polymyxin was 50.7%. The total bacterial clearance rate was 44.2%, the total incidence of AKI was 37.2%, the recovery rate of AKI was 35%, and the incidence range of polymyxin B-related AKI was 10.2–37.2%. Logistic multivariate regression analysis showed that the predictors of AKI in elderly patients were high APACHE II score, long duration of polymyxin, chronic renal insufficiency and ineffective outcome; the ROC curve showed that the cutoff value for predicting AKI was a serum creatinine concentration of 73 mmol/L before polymyxin B use, and the AUC was 0.931. Conclusions Rational use of polymyxin B is safe and effective in elderly patients with CRO infection, and its effective outcome can improve the recovery rate of AKI.

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“…The survival was no difference in 28-day mortality in patients that received 100, 150, 200 mg/day PMB. Some studies found that there was no difference in PMB daily dose between survivors and nonsurvivors [ 20 , 30 ]. But other studies suggested that the daily dose of PMB treatment failure in CR-GNB infections among critically ill patients was lower than success [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes and safety of polymyxin B in the treatment of carbapenem-resistant Gram-negative bacterial infections: a real-world multicenter study

Zhang

Duan

et al. 2021

J Transl Med

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Background High morbidity and mortality due to carbapenem-resistant Gram-negative bacilli (CR-GNB) has led to the resurgence of polymyxin B (PMB) use in the last decade. The aim of our multicenter, real-world study was to evaluate the effectiveness and safety of PMB in the treatment of CR-GNB infections. Methods The real-world study included patients treated with intravenous PMB for at least 7 days during the period of October 2018 through June 2019. Associations between these clinical features and 28-day mortality or all-cause hospital mortality were explored through univariate analyses and multivariable logistic regression. Results The study included 100 patients. Many patients presented with combined chronic conditions, septic shock, mechanical ventilation, and the presence of Klebsiella pneumoniae. The mean duration of PMB therapy was 11 days (range 7–38 days). Temperature (38 °C vs 37.1 °C), white blood cells (14.13 × 109/l vs 9.28 × 109/l), C-reactive protein (103.55 ug/l vs 47.60 ug/l), procalcitonin (3.89 ng/ml vs 1.70 ng/ml) and APACHE II levels (17.75 ± 7.69 vs 15.98 ± 7.95) were significantly decreased after PMB treatment. The bacteria eradication rate was 77.65%. The overall mortality at discharge was 15%, and 28-day mortality was 40%. Major adverse reactions occurred in 16 patients. Nephrotoxicity was observed in 7 patients (7%). Conclusions Our results provide positive clinical and safety outcomes for PMB in the treatment of CR-GNB. Timely and appropriate use of PMB may be particularly useful in treating patients with sepsis in CR-GNB infections.

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A Comparison of Adjusted Versus Unadjusted Doses of Polymyxin B Based on Renal Function and Incidence of Acute Kidney Injury

Abstract: The results from this study support the use of polymyxin B without any dose adjustment in the setting of renal impairment.

Cited by 8 publications

References 37 publications

Polymyxin B in Patients With Renal Impairment: Is It Necessary to Adjust Dose?

Polymyxin B in Patients With Renal Impairment: Is It Necessary to Adjust Dose?

Efficacy and nephrotoxicity of polymyxin B in elderly patients with carbapenem resistant bacterial infection

Clinical outcomes and safety of polymyxin B in the treatment of carbapenem-resistant Gram-negative bacterial infections: a real-world multicenter study

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