Trial reportCritical care (London, England)2023
Polymyxin B therapy based on therapeutic drug monitoring in carbapenem-resistant organisms sepsis: the PMB-CROS randomized clinical trial.
Trial report in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 21 citations in OpenAlex.
- Nephrotoxicity of polymyxin B and colistin sulfate in patients with multidrug-resistant gram-negative bacteria infections: a parametric time-to-event analysis.International journal of clinical pharmacy · 2026Article
- A population pharmacokinetic model library for polymyxin B: clinical implementation of model-informed precision dosing.Frontiers in pharmacology · 2026Article
- Therapeutic Monitoring of Polymyxin B in Critically Ill Patients with Carbapenem-Resistant Organisms: Evaluation Based on Steady-State Trough and Peak Concentrations.Drug design, development and therapy · 2026Article
- Real-World Experience with High- versus Low-Dose Polymyxin B for Pulmonary Infections: A Retrospective Cohort Study.Infection and drug resistance · 2026Article
- Article
- Optimizing Polymyxin B Therapy in Critical Care: Pharmacokinetic Insights and Clinical Outcomes in a Retrospective Cohort Study.Infectious diseases and therapy · 2025Article
- Early appropriate therapy with polymyxin B reduces the mortality in burn sepsis caused by carbapenem-resistant gram-negative bacteria: a retrospective analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Clinical outcomes and pharmacokinetics/pharmacodynamics of intravenous polymyxin B treatment for various site carbapenem-resistant gram-negative bacterial infections: a prospective observational multicenter study.Antimicrobial agents and chemotherapy · 2025Observational
- Article
- Current Therapeutic Approaches for Multidrug-Resistant and Extensively Drug-ResistantAntibiotics (Basel, Switzerland) · 2024Review
- Comparative pharmacokinetics of polymyxin B in critically ill elderly patients with extensively drug-resistant gram-negative bacteria infections.Frontiers in pharmacology · 2024Article
- Editorial: Combinational therapy and nanotechnologies in combating pathogenic microbes and antibiotic resistance.Frontiers in pharmacology · 2024Article
- Comprehensive analysis and novel insights into the efficacy of polymyxin B sulfate in the treatment of sepsis caused by carbapenem-resistant gram-negative bacteria.American journal of translational research · 2024Article
- Efficiency of polymyxin B treatment against nosocomial infection: a systematic review and meta-analysis.Frontiers in medicine · 2024Article
- Evaluation of polymyxin B AUC/MIC ratio for dose optimization in patients with carbapenem-resistantFrontiers in microbiology · 2023Article
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Authors and funding
15 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThe appropriate administration regimen of polymyxin B is yet controversial. The present study aimed to explore the optimal dose of polymyxin B under therapeutic drug monitoring (TDM) guidance.
methodsIn China's Henan province, 26 hospitals participated in a randomized controlled trial. We included patients with sepsis caused by carbapenem-resistant Gram-negative bacteria (CR-GNB) susceptible to polymyxin B. The patients were randomly divided into a high-dose (HD) group or a low-dose (LD) group and received 150 mg loading dose, 75 mg every 12 h and 100 mg loading dose, 50 mg every 12 h, respectively. TDM was employed to determine if the dose of polymyxin B needs adjustment based on the area under the concentration-time curve across 24 h at a steady state (ssAUC
resultsThis trial included 311 patients, with 152 assigned to the HD group and 159 assigned to the LD group. Intention-to-treat analysis showed that the 14-day clinical response was non-significant (p = 0.527): 95/152 (62.5%) in the HD group and 95/159 (59.7%) in the LD group. Kaplan-Meier's 180-day survival curve showed survival advantage in the HD group than in the LD group (p = 0.037). More patients achieved the target ssAUC
conclusionA fixed polymyxin B loading dose of 150 mg and a maintenance dose of 75 mg every 12 h was safe for patients with sepsis caused by CR-GNB and improves long-term survival. The increased AUC was associated with increased incidence of AKI, and TDM results were valued to prevent AKI. Trial registration Trial registration ClinicalTrials.gov: ChiCTR2100043208, Registration date: January 26, 2021.
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