Research advances on individualized medication of polymyxin B in patients with renal insufficiency
10.3760/cma.j.cn114015-20231211-00883
- VernacularTitle:多黏菌素B在肾功能不全患者中的个体化用药研究进展
- Author:
Siyao DONG
1
;
Shuxuan CHEN
;
Yan'gai WANG
;
Bing CHEN
;
Xiangrong BAI
Author Information
1. 首都医科大学宣武医院药学部，国家老年疾病临床医学研究中心，北京 100053
- Publication Type:Journal Article
- Keywords:
Polymyxin B;
Gram-negative bacteria;
Renal insufficiency;
Hemofiltration;
Drug toxicity;
Individualized medication
- From:
Adverse Drug Reactions Journal
2024;26(5):307-311
- CountryChina
- Language:Chinese
-
Abstract:
Polymyxin B is a cyclopeptide antibiotic drug with a narrow therapeutic window and critical nephrotoxicity. However, with the emergence of carbapenem-resistant organisms and the increase of multidrug resistant and polydrug resistant, the clinical value of polymyxin B was emphasized. It has become the last defense against polydrug resistant Gram-negative bacterial infections. The pharmacokinetic process of polymyxin B is affected by physiological and pathological changes in critically ill patients. At present, guidelines and consensus do not recommend dose adjustment based on the severity of renal injury, there is a lack of basis for dosage selection in patients receiving continuous renal replacement therapy, and different views exist in some pharmacokinetic studies and clinical studies. However, it is helpful to improve disease prognosis and reduce the risk of nephrotoxicity to carry out therapeutic drug monitoring of polymyxin B in patients with renal insufficiency, to adjust the dose according to the monitoring results, and to realize precision medication.
