AUTHOR=Jia Xuedong , Yin Zhao , Zhang Wan , Guo Conghui , Du Shuzhang , Zhang Xiaojian 

TITLE=Effectiveness and Nephrotoxicity of Intravenous Polymyxin B in Carbapenem-Resistant Gram-Negative Bacterial Infections Among Chinese Children

JOURNAL=Frontiers in Pharmacology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.902054

DOI=10.3389/fphar.2022.902054

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> No clinical study on the use of polymyxin B in Chinese children has been reported, thus making it difficult for pediatric clinicians to rationally select these drugs.</p><p><bold>Methods:</bold> A retrospective analysis of children treated with polymyxin B during hospitalization in a hospital from June 2019 to June 2021 was conducted to analyze its effectiveness and the incidence of acute kidney injury (AKI) during treatment with polymyxin B.</p><p><bold>Results:</bold> A total of 55 children were included in this study, and the results showed that the intravenous polymyxin B-based regimen had an effective rate of 52.7% in the treatment of Carbapenem-resistant Gram-negative bacterial (CR-GNB) infection in children. The results of the subgroup analysis showed that the course of treatment was longer in the favorable clinical response group than in the unfavorable outcome group (<italic>p</italic> = 0.027) and that electrolyte disturbances in children during the course of treatment could lead to unfavorable clinical outcomes (<italic>p</italic> = 0.042). The risk of incidence of AKI during treatment was 27.3%, and the all-cause mortality rate in the children on their discharge from the hospital was 7.3%.</p><p><bold>Conclusion:</bold> Polymyxin B can be used as a salvage therapy for CR-GNB infection in children when no other susceptible antibiotics are available, and the monitoring of kidney function should be strengthened.</p>