{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:01:32Z","timestamp":1789725692723,"version":"4.0.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council, Taiwan","doi-asserted-by":"publisher","award":["113-2314-B-002-126-MY3"],"award-info":[{"award-number":["113-2314-B-002-126-MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council, Taiwan","doi-asserted-by":"publisher","award":["114-2314-B-002-217-MY3"],"award-info":[{"award-number":["114-2314-B-002-217-MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009210","name":"Taiwan Food and Drug Administration","doi-asserted-by":"publisher","award":["MOHW115-FDA-D-212-134451"],"award-info":[{"award-number":["MOHW115-FDA-D-212-134451"]}],"id":[{"id":"10.13039\/100009210","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["114-SS0012"],"award-info":[{"award-number":["114-SS0012"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NTUH-TMU Joint Research Program","award":["115-TMU112"],"award-info":[{"award-number":["115-TMU112"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The optimal weight-based maintenance dose of polymyxin B is not established. We evaluated dose\u2013response relationships for 28-day mortality and nephrotoxicity and explored a dose threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-centre retrospective cohort, hospitalized adults received a first intravenous polymyxin B course (June 2025 to February 2026); the maintenance dose (mg\/kg\/day) was the exposure. Main outcomes were 28-day mortality and nephrotoxicity, defined by a creatinine-clearance criterion (\u226550% fall, or \u200a\u2265\u200a25% with pre-existing dysfunction); renal injury was also graded by the risk, injury, failure, loss and end-stage kidney disease (RIFLE) classification. We used clinically selected dose categories (2.5, 2.75 and 3.0\u2005mg\/kg\/day), exploratory classification and regression tree (CART) analysis, multivariable logistic regression and a desirability of outcome ranking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mortality cohort comprised 208 patients (28-day mortality 41.3%) and the nephrotoxicity cohort 163 (nephrotoxicity 49.7%). Mortality declined across dose categories in univariable analysis (trend P\u200a=\u200a0.05) but was not independently associated with dose after adjustment. Nephrotoxicity increased with dose, reaching 73% at \u200a\u22653.0\u2005mg\/kg\/day; CART identified a threshold at 2.74\u2005mg\/kg\/day, above which the RIFLE grade was worse (62.3% of comparisons; P\u200a=\u200a0.006). Multivariable analysis confirmed this (adjusted odds ratio 2.60, 95% confidence interval 1.25\u20135.43). The desirability of outcome ranking did not differ across dose groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A higher polymyxin B maintenance dose was associated with increased nephrotoxicity, particularly above approximately 2.75\u2005mg\/kg\/day. The mortality estimates were imprecise and did not exclude a clinically important effect. This single-centre threshold is hypothesis-generating and requires validation before it could inform a clinical dose ceiling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag322","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:53:37Z","timestamp":1788954817000},"source":"Crossref","is-referenced-by-count":0,"title":["Weight-based polymyxin B dosing for mortality and nephrotoxicity: an exploratory dose\u2013response study"],"prefix":"10.1093","volume":"81","author":[{"given":"Sung-Ching","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Tao","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Medicine, National Taiwan University Cancer Center , Taipei 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