{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:33:03Z","timestamp":1781649183502,"version":"3.54.5"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polymyxin B is increasingly used against multidrug-resistant Gram-negative bacteria but carries a risk of acute kidney injury (AKI). Burn patients are particularly vulnerable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 44-year-old male with 66% TBSA burns and sepsis received polymyxin B (50\u202fmg q12h, then escalated to 100\u202fmg q12h). Serum creatinine rose from 59 to 163\u202f\u03bcmol\/L within 3\u202fdays, meeting KDIGO AKI criteria. No other nephrotoxic agents were used. The Naranjo score was 5, indicating probable polymyxin B-induced AKI. After dose reduction to 50\u202fmg q12h, renal function improved without discontinuing therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In burn patients, early renal function monitoring (within 3\u202fdays) and dose adjustment based on infection response and renal biomarkers are critical. Therapeutic drug monitoring is recommended when available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1817208","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:57:09Z","timestamp":1778129829000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Polymyxin B-induced acute kidney injury in a burn patient: a case report and pharmaceutical care"],"prefix":"10.3389","volume":"13","author":[{"given":"Shanshan","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Jinan Central Hospital","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.jgar.2013.03.012","article-title":"Global survey of polymyxin use: a call for international guidelines","volume":"1","author":"Wertheim","year":"2013","journal-title":"J Glob Antimicrob Resist"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1517\/14740338.2015.1088520","article-title":"The safety of polymyxin antibiotics","volume":"14","author":"Kelesidis","year":"2015","journal-title":"Expert Opin Drug Saf"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"106869","DOI":"10.1016\/j.ijantimicag.2023.106869","article-title":"Antimicrobial resistance surveillance: China's nearly 40-year effort","volume":"62","author":"Ding","year":"2023","journal-title":"Int J Antimicrob Agents"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.jmii.2022.02.001","article-title":"Recommendations and guidelines for the treatment of infections due to multidrug resistant organisms","volume":"55","author":"Sy","year":"2022","journal-title":"J Microbiol Immunol Infect"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis","volume":"399","year":"2022","journal-title":"Lancet"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae403","article-title":"Infectious Diseases Society of America 2024 guidance on the treatment of antimicrobial-resistant gram-negative infections","volume":"7","author":"Tamma","year":"2024","journal-title":"Clin Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3390\/ph13050083","article-title":"Polymyxin delivery systems: recent advances and challenges","volume":"13","author":"Dubashynskaya","year":"2020","journal-title":"Pharmaceuticals (Basel)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"292","DOI":"10.3760\/cma.j.cn112147-20201109-01091","article-title":"Chinese thoracic society; Chinese Society of Critical Care Medicine","volume":"44","year":"2021","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1016\/j.burns.2023.05.003","article-title":"Surviving sepsis after burn campaign","volume":"49","author":"Greenhalgh","year":"2023","journal-title":"Burns"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1089\/sur.2020.102","article-title":"Burn infection and burn sepsis","volume":"22","author":"D'Abbondanza","year":"2021","journal-title":"Surg Infect"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"c179","DOI":"10.1159\/000339789","article-title":"KDIGO clinical practice guidelines for acute kidney injury","volume":"120","author":"Khwaja","year":"2012","journal-title":"Nephron Clin Pract"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1038\/s41581-023-00769-y","article-title":"Acute kidney injury in patients with burns","volume":"20","author":"Legrand","year":"2024","journal-title":"Nat Rev Nephrol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1002\/phar.2209","article-title":"International consensus guidelines for the optimal use of the Polymyxins: endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti-infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP)","volume":"39","author":"Tsuji","year":"2019","journal-title":"Pharmacotherapy"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.3760\/cma.j.issn.2095-4352.2019.10.003","article-title":"Chinese research hospital association of evidence base and translational infectious diseases","volume":"31","year":"2019","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"R27","DOI":"10.1186\/cc3995","article-title":"Toxicity of polymyxins: a systematic review of the evidence from old and recent studies","volume":"10","author":"Falagas","year":"2006","journal-title":"Crit Care"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"109","DOI":"10.3760\/cma.j.cn115354-20240124-00069","article-title":"Neurological Intensive Care Expert Committee of Neurosurgical Branch of Chinese Medical Association, China Neurosurgical Intensive Care Management Collaborative Group. Shenjing zhongzheng huanzhe zhongshu shenjing xitong ganran duonianjunsu jubu yingyong de Zhongguo zhuanjia gongshi (2024) [consensus of Chinese experts on topical application of polymyxin in severe central nervous system infections (2024)]","volume":"23","year":"2024","journal-title":"Chinese J Neuromedicine"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"153","DOI":"10.4103\/0972-5229.45074","article-title":"Safety and efficacy of polymyxin B in multidrug resistant gram-negative severe sepsis and septic shock","volume":"12","author":"Ramasubban","year":"2008","journal-title":"Indian J Crit Care Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.jinf.2012.01.015","article-title":"Incidence and predictors of acute kidney injury associated with intravenous polymyxin B therapy","volume":"65","author":"Kubin","year":"2012","journal-title":"J Infect"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"17","DOI":"10.14053\/j.cnki.ppcr.202301004","article-title":"Duonianjunsu B xiangguanxing jixing shen sunshang weixian yinsu de zhenshi shijie yanjiu[a real-world study of risk factors for polymyxin B-related acute kidney injury]","volume":"26","author":"Tu","year":"2023","journal-title":"Practical Pharmacy Clinical Remedies"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"95","DOI":"10.3760\/cma.j.cn114015-20220512-00422","article-title":"Zhongzhengganranhuanzhe duonianjunsu B xiangguan jixingshensunshang de fashengqingkuang ji weixianyinsu fenxi [occurrence and risk factors of acute kidney injury associated with polymyxin B in patients with severe infection]","volume":"25","author":"Pan","year":"2023","journal-title":"Adverse Drug Reactions J"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.3760\/cma.j.issn.1671-0282.2023.10.016","article-title":"Jingmaiyong duonianjunsu B zhi yaowuxiangguanxing shensunshangde weixianyinsu fenxi[risk factors analysis of drug-induced kidney injury by intravenous polymyxin B]","volume":"32","author":"Wu","year":"2023","journal-title":"Chinese Journal of Emergency Medicine"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.ijid.2022.01.055","article-title":"Risk factors for polymyxin B-associated acute kidney injury","volume":"117","author":"Chang","year":"2022","journal-title":"Int J Infect Dis"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"7000","DOI":"10.1128\/AAC.00844-15","article-title":"Clinical outcomes associated with polymyxin B dose in patients with bloodstream infections due to carbapenem-resistant gram-negative rods","volume":"59","author":"Nelson","year":"2015","journal-title":"Antimicrob Agents Chemother"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1093\/jac\/dku561","article-title":"Risk factors for acute kidney injury (AKI) in patients treated with polymyxin B and influence of AKI on mortality: a multicentre prospective cohort study","volume":"70","author":"Rigatto","year":"2015","journal-title":"J Antimicrob Chemother"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1817208\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:57:15Z","timestamp":1778129835000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1817208\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":24,"alternative-id":["10.3389\/fmed.2026.1817208"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1817208","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]},"article-number":"1817208"}}