{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:12:45Z","timestamp":1789719165305,"version":"4.0.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T00:00:00Z","timestamp":1743206400000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Shanghai Talent Awards","award":["LJ2016-01"],"award-info":[{"award-number":["LJ2016-01"]}]},{"DOI":"10.13039\/501100003399","name":"Shanghai Municipal Science and Technology Commission","doi-asserted-by":"publisher","award":["19411964900"],"award-info":[{"award-number":["19411964900"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173896"],"award-info":[{"award-number":["82173896"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Aerosolized polymyxin B delivery was a promising approach for the treatment of ventilator-associated pneumonia (VAP). However, there were little data on the concentrations of polymyxin B in epithelial lining fluid (ELF), which impedes the optimal use of aerosolized polymyxin B in clinics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We present four cases of patients diagnosed with VAP caused by Gram-negative bacteria, who enrolled in a prospective, therapeutic drug monitoring (TDM) study of polymyxin B. The patients were treated with aerosolized and intravenous administration of polymyxin B. Polymyxin B concentrations in both ELF and plasma were determined using validated LC-MS\/MS methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All four patients achieved bacterial eradication, with three of them reaching clinical improvement or cure. Following aerosol administration (25 or 50\u2005mg, q12h) and intravenous infusion (50\u2212100\u2005mg, q12h) of polymyxin B, it was observed that the concentrations of polymyxin B in ELF were significantly higher in ELF (20.6\u221297.6\u2005mg\/L) compared to those in plasma (1.19\u22125.16\u2005mg\/L) during the steady sate. The area under the concentration\u2212time curve for 24\u2005h (AUC24h,ELF) ranged from 283.6 to 1872.9\u2005mg\u2022h\/L.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study presented polymyxin B concentrations in ELF following aerosolized delivery, supporting its clinical use from a PK\/PD perspective. Following combined aerosol and intravenous administration, polymyxin B achieved notably higher concentrations in ELF than those observed in plasma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf023","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T19:30:24Z","timestamp":1743449424000},"source":"Crossref","is-referenced-by-count":5,"title":["Aerosolized delivery resulting in high polymyxin B concentration levels in epithelial lining fluid ensures efficacy in ventilator-associated pneumonia"],"prefix":"10.1093","volume":"7","author":[{"given":"Xiaofen","family":"Liu","sequence":"first","affiliation":[{"name":"Institute of Antibiotics, Huashan Hospital, Fudan University , Shanghai 200040 ,","place":["China"]},{"name":"Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of the People\u2019s Republic of China , Shanghai 200040 ,","place":["China"]},{"name":"National Clinical Research Centre for Aging 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University , Shanghai 200040 ,","place":["China"]},{"name":"Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of the People\u2019s Republic of China , Shanghai 200040 ,","place":["China"]},{"name":"National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University , Shanghai 200040 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaxin","family":"Fan","sequence":"additional","affiliation":[{"name":"Institute of Antibiotics, Huashan Hospital, Fudan University , Shanghai 200040 ,","place":["China"]},{"name":"Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission of the People\u2019s Republic of China , Shanghai 200040 ,","place":["China"]},{"name":"National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University , Shanghai 200040 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