ArticleThe Journal of antimicrobial chemotherapy2026
Weight-based polymyxin B dosing for mortality and nephrotoxicity: an exploratory dose-response study.
Article in The Journal of antimicrobial chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectivesThe optimal weight-based maintenance dose of polymyxin B is not established. We evaluated dose-response relationships for 28-day mortality and nephrotoxicity and explored a dose threshold.
methodsIn this single-centre retrospective cohort, hospitalized adults received a first intravenous polymyxin B course (June 2025 to February 2026); the maintenance dose (mg/kg/day) was the exposure. Main outcomes were 28-day mortality and nephrotoxicity, defined by a creatinine-clearance criterion (≥50% fall, or ≥ 25% with pre-existing dysfunction); renal injury was also graded by the risk, injury, failure, loss and end-stage kidney disease (RIFLE) classification. We used clinically selected dose categories (2.5, 2.75 and 3.0 mg/kg/day), exploratory classification and regression tree (CART) analysis, multivariable logistic regression and a desirability of outcome ranking.
resultsThe mortality cohort comprised 208 patients (28-day mortality 41.3%) and the nephrotoxicity cohort 163 (nephrotoxicity 49.7%). Mortality declined across dose categories in univariable analysis (trend P = 0.05) but was not independently associated with dose after adjustment. Nephrotoxicity increased with dose, reaching 73% at ≥3.0 mg/kg/day; CART identified a threshold at 2.74 mg/kg/day, above which the RIFLE grade was worse (62.3% of comparisons; P = 0.006). Multivariable analysis confirmed this (adjusted odds ratio 2.60, 95% confidence interval 1.25-5.43). The desirability of outcome ranking did not differ across dose groups.
conclusionsA higher polymyxin B maintenance dose was associated with increased nephrotoxicity, particularly above approximately 2.75 mg/kg/day. The mortality estimates were imprecise and did not exclude a clinically important effect. This single-centre threshold is hypothesis-generating and requires validation before it could inform a clinical dose ceiling.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.