1. Efficacy and nephrotoxicity of polymyxin B in elderly patients with carbapenem resistant bacterial infection
- Author
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G. L. Xia, X. Xu, X. B. You, X. Wang, D. D. Feng, S. Lei, and R. L. Jiang
- Subjects
Polymyxin B ,Elderly ,Acute kidney injury ,Infection ,Carbapenem-resistant organism ,Therapeutics. Pharmacology ,RM1-950 ,Infectious and parasitic diseases ,RC109-216 ,Microbiology ,QR1-502 - Abstract
Abstract Background To study the efficacy and nephrotoxicity of polymyxin B in the treatment of elderly patients with carbapenem-resistant organism (CRO) infection. Methods The clinical and microbiological data of patients with CRO-infected sepsis treated with polymyxin B were retrospectively analyzed. The effective rate, bacterial clearance, incidence and recovery rate of acute renal injury (AKI) and prognosis-related indicators in AKI at different stages were compared. Results The effective rate of 215 elderly patients with CRO infection treated with polymyxin was 50.7%. The total bacterial clearance rate was 44.2%, the total incidence of AKI was 37.2%, the recovery rate of AKI was 35%, and the incidence range of polymyxin B-related AKI was 10.2–37.2%. Logistic multivariate regression analysis showed that the predictors of AKI in elderly patients were high APACHE II score, long duration of polymyxin, chronic renal insufficiency and ineffective outcome; the ROC curve showed that the cutoff value for predicting AKI was a serum creatinine concentration of 73 mmol/L before polymyxin B use, and the AUC was 0.931. Conclusions Rational use of polymyxin B is safe and effective in elderly patients with CRO infection, and its effective outcome can improve the recovery rate of AKI.
- Published
- 2023
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