Clinical outcomes associated with polymyxin B dose in patients with bloodstream infections due to carbapenem-resistant Gram-negative rods

Antimicrobial Agents and Chemotherapy
Brian C NelsonChristine J Kubin

Abstract

There is significant variation in the use of polymyxin B (PMB), and optimal dosing has not been defined. The purpose of this retrospective study was to evaluate the relationship between PMB dose and clinical outcomes. We included patients with bloodstream infections (BSIs) due to carbapenem-resistant Gram-negative rods who received ≥48 h of intravenous PMB. The objective was to evaluate the association between PMB dose and 30-day mortality, clinical cure at day 7, and development of acute kidney injury (AKI). A total of 151 BSIs were included. The overall 30-day mortality was 37.8% (54 of 151), and the median PMB dosage was 1.3 mg/kg (of total body weight)/day. Receipt of PMB dosages of <1.3 mg/kg/day was significantly associated with 30-day mortality (46.5% versus 26.3%; P = 0.02), and this association persisted in multivariable analysis (odds ratio [OR] = 1.58; 95% confidence interval [CI] = 1.05 to 1.81; P = 0.04). Eighty-two percent of patients who received PMB dosages of <1.3 mg/kg/day had baseline renal impairment. Clinical cure at day 7 was not significantly different between dosing groups. AKI was more common in patients receiving PMB dosages of ≥250 mg/day (66.7% versus 32.0%; P = 0.03), and this association persisted ...Continue Reading

Citations

Dec 19, 2015·Expert Review of Clinical Pharmacology·Marguerite L MonogueDavid P Nicolau
Dec 29, 2016·Biochemistry·Olapeju BolarinwaJianfeng Cai
Oct 19, 2017·Antimicrobial Agents and Chemotherapy·Josiane F JohnAlexandre P Zavascki
Jan 10, 2018·Antimicrobial Agents and Chemotherapy·Christine J KubinMichael T Yin
Feb 16, 2018·Clinical Microbiology Reviews·Jesús Rodríguez-BañoAlvaro Pascual
May 31, 2018·Antimicrobial Agents and Chemotherapy·Adeola OkoduwaYanina Dubrovskaya
Apr 26, 2017·Antimicrobial Agents and Chemotherapy·Nikolas J OnufrakKeith S Kaye
Nov 2, 2016·Antimicrobial Agents and Chemotherapy·Visanu ThamlikitkulVincent H Tam
Oct 10, 2018·Current Opinion in Infectious Diseases·Aaron J HeffernanJason A Roberts
Nov 1, 2018·Current Opinion in Infectious Diseases·Mario TumbarelloHelen Giamarellou
May 7, 2020·Antioxidants & Redox Signaling·Bi-O KimYou-Hee Cho
Aug 2, 2017·Critical Care Research and Practice·Suneel Kumar GargHanmant Barkate
Oct 4, 2020·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Rajeev SomanBalaji Veeraraghavan
Dec 29, 2020·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Florian WagenlehnerJason M Pogue
Jan 14, 2021·International Journal of Clinical Pharmacy·Jiali ZhangHaibin Dai
Feb 25, 2021·Drug Design, Development and Therapy·Wenrui SunGuanyang Lin
Jun 8, 2021·Antimicrobial Agents and Chemotherapy·Michael MaynardArnold Louie

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