Clinical outcomes and pharmacokinetics/pharmacodynamics of intravenous polymyxin B treatment for various site carbapenem-resistant gram-negative bacterial infections: a prospective observational multicenter study

• DOI: 10.1128/aac.01859-24
• Publication Date: 2025-03-06T14:00:41Z
• Authors: Zhenwei Yu; Huangdu Hu; Xiaofen Liu; Jieqiong Liu; Lingyan Yu; Anqi Wei; Chuanwei Xin; Yongxiong Gan; Shu Lei; Li Zhuang; Yanfei Shen; Xiaoxing Du; Jianping Zhu; Yi Yang; Gang Liang; Feng Guo; Jing Zhang; Yunsong Yu
• Keywords: Carbapenem; Pharmacodynamics; Polymyxin; Gram

Polymyxin B, a last resort for carbapenem-resistant gram-negative bacteria (CRGNB) infections, has infection site-specific pharmacokinetic/pharmacodynamic (PK/PD) properties. However, there is little clinical evidence to support optimal exposures of polymyxin B different site infections. We performed prospective, observational, multicenter study evaluate the outcomes and PK/PD intravenous treatment various CRGNB The main were 14-day all-cause mortality nephrotoxicity, secondary 28-day response. area under curves (AUCs) determined, their associations with analyzed by stratification based on site. A total 312 patients ultimately enrolled from 10 research centers. overall was 29.5%, those lower respiratory tract (LRTI), intra-abdominal (IAI), bloodstream (BSI) 32.3%, 19.7%, 30.3%, respectively. rate 38.1%, while LRTI had highest (41.4%) IAI lowest (34.8%). response 46.2%, which similar among subgroups. AKI 60.9%. An AUC greater than 50 mg∙h/L related in but not patients, led significant difference analysis. an independent risk factor cutoff value 76 mg∙h/L. results would be helpful personalized dosing monitoring B.CLINICAL TRIALSThis registered Chinese Clinical Trial Registry as ChiCTR2200056667.