We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
A retrospective observational study of the treatment with polymyxin B for liver transplantation recipients infected by multidrug‐resistant gram‐negative bacteria.
- Authors
Yu, Ling‐Ling; Shi, Xiao‐Ping; Huang, Jun‐Feng; Gong, Yu; Cui, Chun‐Xiao; Wang, Ting
- Abstract
What Is Known and Objective: Only a few studies about polymyxin B (PMB) against multidrug‐resistant gram‐negative bacteria (MDR GNB) infection were conducted in liver transplantation recipients (LTRs). The purpose of this study was to investigate the efficacy and safety of PMB in the treatment of MDR‐GNB in liver transplant recipients and to determine the risk factors affecting clinical cure and 30‐day all‐cause mortality. Methods: Data of LTRs receiving PMB from January 2016 to February 2020 were collected. Clinical cure and 30‐day all‐cause mortality were the main efficacy outcomes, while the incidence of nephrotoxicity, neurotoxicity, and hyperpigmentation of PMB was the main safety outcome. Results and Discussion: Data of 42 LTRs were included. Clinical cure with PMB was observed in 27 recipients (64.3%), and the 30‐day all‐cause mortality rate was 31.0% (13/42). The incidence of acute kidney injury (AKI), neurotoxicity, and hyperpigmentation was 57.1% (16/28), 4.8% (2/42), and 16.7% (7/42), respectively. Logistic regression analysis showed that Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.203; 95% CI, 1.016–1.423, p = 0.032) was an independent risk factor for 30‐day all‐cause mortality, whereas renal replacement therapy (OR, 0.128; 95% CI, 0.019–0.860, p = 0.034) was an independent risk factor for clinical cure with PMB. What Is New and Conclusions: This is the first study to evaluate the application of PMB in LTRs. If there were no better therapeutic options left for LTRs other than PMB, it can be used against MDR GNB infection in LTRs. We should closely observe adverse events or reactions, and adjust the dose based on the balance of efficacy and safety.
- Subjects
MORTALITY risk factors; DRUG efficacy; CAUSES of death; NEPHROTOXICOLOGY; SCIENTIFIC observation; CONFIDENCE intervals; PATIENTS; RETROSPECTIVE studies; HYPERPIGMENTATION; MANN Whitney U Test; FISHER exact test; TREATMENT effectiveness; T-test (Statistics); MULTIDRUG resistance; CHI-squared test; POLYMYXIN B; GRAM-negative bacterial diseases; LIVER transplantation; LOGISTIC regression analysis; ODDS ratio; DATA analysis software; TRANSPLANTATION of organs, tissues, etc.; PATIENT safety; ACUTE kidney failure; PHARMACODYNAMICS
- Publication
Journal of Clinical Pharmacy & Therapeutics, 2022, Vol 47, Issue 10, p1563
- ISSN
0269-4727
- Publication type
Article
- DOI
10.1111/jcpt.13702