Chinese consensus guidelines for therapeutic drug monitoring of polymyxin B, endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society.

Xiaofen Liu; Chenrong Huang; Phillip J Bergen; Jian LI; Jingjing Zhang; Yijian Chen; Yongchuan Chen; Beining Guo; Fupin HU; Jinfang HU; Linlin HU; Xin LI; Hongqiang Qiu; Hua Shao; Tongwen Sun; Yu Wang; Ping XU; Jing Yang; Yong Yang; Zhenwei YU; Bikui Zhang; Huaijun Zhu; Xiaocong Zuo; Yi Zhang; Liyan Miao; Jing Zhang

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Chinese consensus guidelines for therapeutic drug monitoring of polymyxin B, endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society.

Author: Xiaofen LIU ¹ ; Chenrong HUANG ² ; Phillip J BERGEN ³ ; Jian LI ³ ; Jingjing ZHANG ² ; Yijian CHEN ¹ ; Yongchuan CHEN ⁴ ; Beining GUO ¹ ; Fupin HU ¹ ; Jinfang HU ⁵ ; Linlin HU ⁶ ; Xin LI ⁷ ; Hongqiang QIU ⁸ ; Hua SHAO ⁶ ; Tongwen SUN ⁹ ; Yu WANG ¹ ; Ping XU ¹⁰ ; Jing YANG ⁹ ; Yong YANG ¹¹ ; Zhenwei YU ¹² ; Bikui ZHANG ¹⁰ ; Huaijun ZHU ¹³ ; Xiaocong ZUO ¹⁴ ; Yi ZHANG ¹⁵ ; Liyan MIAO ¹⁶ ; Jing ZHANG ¹⁷
Author Information

1. Institute of Antibiotics, Huashan Hospital, Fudan University / Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of the People's Republic of China / National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
2. Department of Clinical Pharmacology, the First Affiliated Hospital of Soochow University / Institute for Interdisciplinary Drug Research and Translational Sciences, College of Pharmaceutical Science, Soochow University, Suzhou 215000, China.
3. Biomedicine Discovery Institute and Department of Microbiology, Monash University, Melbourne, VIC 3800, Australia.
4. The Southwest Hospital of Army Medical University, Chongqing 400038, China.
5. The First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
6. Zhongda Hospital Southeast University, Nanjing 210009, China.
7. The Third Hospital of Changsha, Changsha 410035, China.
8. Fujian Medical University Union Hospital, Fuzhou 350001, China.
9. The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
10. The Second Xiangya Hospital of Central South University, Changsha 410011, China.
11. People's Hospital of Sichuan Province, Chengdu 610072, China.
12. Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310020, China.
13. Nanjing Drum Tower Hospital, Nanjing 210008, China.
14. The Third Xiangya Hospital of Central South University, Changsha 430100, China.
15. Tianjin First Central Hospital, Tianjin 300190, China.
16. Department of Clinical Pharmacology, the First Affiliated Hospital of Soochow University / Institute for Interdisciplinary Drug Research and Translational Sciences, College of Pharmaceutical Science, Soochow University, Suzhou 215000, China. miaolysuzhou@163.com.
17. Institute of Antibiotics, Huashan Hospital, Fudan University / Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of the People's Republic of China / National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China. zhangj_fudan@aliyun.com.
Publication Type:Journal Article
Keywords: Clinical efficacy; Pharmacokinetics; Polymyxin B; Therapeutic drug monitoring (TDM)
MeSH: Humans; Anti-Bacterial Agents/therapeutic use*; China; Drug Monitoring/methods*; Polymyxin B; Practice Guidelines as Topic
From: Journal of Zhejiang University. Science. B 2023;24(2):130-142
CountryChina
Language:English
Abstract: Polymyxin B, which is a last-line antibiotic for extensively drug-resistant Gram-negative bacterial infections, became available in China in Dec. 2017. As dose adjustments are based solely on clinical experience of risk toxicity, treatment failure, and emergence of resistance, there is an urgent clinical need to perform therapeutic drug monitoring (TDM) to optimize the use of polymyxin B. It is thus necessary to standardize operating procedures to ensure the accuracy of TDM and provide evidence for their rational use. We report a consensus on TDM guidelines for polymyxin B, as endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society. The consensus panel was composed of clinicians, pharmacists, and microbiologists from different provinces in China and Australia who made recommendations regarding target concentrations, sample collection, reporting, and explanation of TDM results. The guidelines provide the first-ever consensus on conducting TDM of polymyxin B, and are intended to guide optimal clinical use.