{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:20:17Z","timestamp":1787887217982,"version":"build-2784847793"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2016YFC1304300"],"award-info":[{"award-number":["2016YFC1304300"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to assess the effectiveness and nephrotoxicity of polymyxin B in critically ill patients with nosocomial pneumonia and to evaluate the utility of its therapeutic drug monitoring (TDM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed patients who received polymyxin B treatment for \u226548\u2009h since the establishment of polymyxin B TDM in a 26\u2010bed tertiary referral intensive care unit. Univariate and multivariate analyses were conducted to assess the variables associated with polymyxin B effectiveness and nephrotoxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 62 patients were enrolled. Most (56.5%) of the patients performed TDM, 54.3% of them reached the therapeutic target of area under curve across 24\u2009h at steady state (AUC<jats:sub>ss,24h<\/jats:sub>) of 50\u2013100\u2009mg\u2009h\u2009L<jats:sup>\u22121<\/jats:sup>, and 10 patients had an AUC<jats:sub>ss,24h<\/jats:sub> value of &lt;50\u2009mg\u2009h\u2009L<jats:sup>\u22121<\/jats:sup>. Thirty\u2010six (58.1) and 31 (50.0%) patients had favorable clinical and microbiological responses, respectively. Reaching the therapeutic target of AUC<jats:sub>ss,24h<\/jats:sub> (odds ratio [OR]\u2009=\u200913.15, <jats:italic>p<\/jats:italic>\u2009=\u20090.015), a favorable microbiological response (OR\u2009=\u200940.80, <jats:italic>p<\/jats:italic>\u2009=\u20090.00), and complicated with septic shock (OR\u2009=\u20090.12, <jats:italic>p<\/jats:italic>\u2009=\u20090.021) were independently associated with favorable clinical outcomes of polymyxin B treatment. The incidence of acute kidney injury (AKI) was 45.2%. A lower creatinine clearance (OR\u2009=\u20090.96, <jats:italic>p<\/jats:italic>\u2009=\u20090.008) and concomitant treatment with loop diuretics (OR\u2009=\u20095.93, <jats:italic>p<\/jats:italic>\u2009=\u20090.046) were predictive of nephrotoxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings show that TDM of polymyxin B is a valuable intervention, and the achievement of its optimal pharmacodynamic target can improve treatment outcome. Renal insufficiency and concomitant treatment with loop diuretics were found to be associated with the risk of nephrotoxicity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13493","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T07:21:33Z","timestamp":1652944893000},"page":"402-412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Effectiveness, nephrotoxicity, and therapeutic drug monitoring of polymyxin B in nosocomial pneumonia among critically ill patients"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5273-3589","authenticated-orcid":false,"given":"Qinghua","family":"Ye","sequence":"first","affiliation":[{"name":"Peking University China\u2010Japan Friendship School of Clinical Medicine  Beijing China"},{"name":"Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine China\u2010Japan Friendship Hospital, 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