Observational studyClinical pharmacology and therapeutics2025
Population Pharmacokinetic/Toxicodynamic Model for Polymyxin B in Critically Ill Patients to Identify the Risk of Nephrotoxicity.
Observational study in Clinical pharmacology and therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Physiologically Based Pharmacokinetic Modeling of Inhaled Polymyxin B: From Rabbit Optimization to Human Predictions.Pharmaceutical research · 2026Article
- RENAsym, a quantitative systems toxicology platform model, designed to predict drug-induced kidney injury indicates polymyxin B and valproate overdose toxicity potential while simultaneously demonstrating acetaminophen and valproate safety at therapeutic levels.Toxicological sciences : an official journal of the Society of Toxicology · 2026Article
- Clinician decision-making for polymyxin dosing in critically ill patients with renal impairment: a qualitative study.Scientific reports · 2026Article
- Comparative Effectiveness of Colistin Sodium versus Polymyxin B Sulfate Against CR-GNB: A Retrospective Cohort Study.Infection and drug resistance · 2026Article
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
Polymyxins are used against highly resistant Gram-negative pathogens, and nephrotoxicity (acute kidney injury, AKI) is the major dose-limiting adverse effect. We aimed to develop a well-informed population pharmacokinetic/toxicodynamic (PK/TD) model using the largest polymyxin B-treated critically ill patient population studied to inform polymyxin B dosing strategies. Critically ill patients receiving intravenous polymyxin B for at least 48 hours were enrolled in an observational study. Serum creatinine (SCr) concentrations were collected from electronic medical records. PK/TD analysis and Monte Carlo simulations were performed to determine the probability of AKI, P(AKI), for clinically relevant treatments. Patients (N = 117) aged 18-94 received intravenous polymyxin B (1.33-6.00 mg/kg/day) for 1-50 days. The changes in SCr were described using an indirect response model. The effects of polymyxin B-induced functional kidney injury were characterized using 9 transit compartments (mean time to onset ~7 days), leading to a reduction in SCr elimination. Sex was identified as a significant covariate for baseline SCr
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