Clinical observation of polymyxin B in the treatment of CRKP-BSI in patients with hematological malignancies
- VernacularTitle:多黏菌素B治疗血液系统恶性肿瘤伴CRKP-BSI的临床观察
- Author:
Na LI
1
;
Nan LIU
1
;
Ailing ZHANG
1
;
Li LI
2
;
Dingming WAN
2
;
Xiaojian ZHANG
3
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China;Henan Provincial Key Laboratory of Precision Clinical Pharmacy，Zhengzhou 450052，China;Henan Provincial Precision Clinical Pharmacy Application and Transformation Engineering Research Center，Zhengzhou 450052，China
2. Dept. of Hematology，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
3. Dept. of Pharmacy，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China;Henan Provincial Key Laboratory of Precision Clinical Pharmacy，Zhengzhou 450052，China
- Publication Type:Journal Article
- Keywords:
polymyxin B;
carbapenem-resistant Klebsiella pneumoniae;
hematologic malignancy;
bloodstream infection
- From:
China Pharmacy
2023;34(4):461-465
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze the efficacy and safety of polymyxin B in the treatment of carbapenem-resistant Klebsiella pneumoniae （CRKP）-bloodstream infection （BSI） in patients with hematologic malignancies. METHODS The medical records of patients with hematologic malignancies with CRKP-BSI who received polymyxin B for at least 3 days in our hospital from September 2019 to June 2021 were retrospectively analyzed. All patients were initially treated with a triple therapy namely polymyxin B+tigecycline+carbapenems for anti-infection therapy. RESULTS A total of 10 patients were enrolled as the study subjects. Eleven strains of CRKP were cultured in blood， including 10 strains of CRKP produced Klebsiella pneumoniae carbapenemase（KPC） and 1 strain of CRKP produced both KPC and metal-beta-lactamase； 9 strains were sensitive to colistin， 7 strains were sensitive to tigecycline， 5 strains were sensitive to amikacin and 2 strains were sensitive to compound sulfamethoxazole. All patients were accompanied by neutropenia， with an average duration of （14.1±6.4） days. They were all characterized by fever， chills and fatigue. After treatment， 6 patients were cured and discharged， 4 patients died of ineffective treatment of septic shock. No serious adverse events related to polymyxin B occurred in all patients. CONCLUSIONS Polymyxin B can be used as a therapeutic drug for CRKP-BSI in patients with hematological malignancies. No serious adverse event related to polymyxin B occurs during the treatment.
