Methods: 20 adult patients who received intravenous polymyxin B at standard dosing (1.5 - 2.5 mg/kg of actual body weight/day) were included. Serial blood samples were obtained from each patient after receiving polymyxin B for at least 48 hours for measurement of polymyxin B concentrations. The primary outcome was polymyxin B exposure at steady state, as reflected by the area under the concentration-time curve (AUC) over 24 hours. The drug exposures in patients with normal renal function (estimated creatinine clearance, CrCL>80 ml/min) were compared to patients with renal insufficiency (CrC<80 ml/min).Results: 7 patients had normal renal function at baseline whereas 13 had renal insufficiency. Mean ± SD AUC of polymyxin B in normal renal function cohort was 44.1 ± 17.1 mg.h/L, as compared to 53.3 ± 17.2 mg.h/L in renal insufficiency cohort (p=0.28). Elimination half-lives of polymyxin B were 8.6 ± 1.7 hours and 10.4 ± 3.2 hours in normal renal function cohort and renal insufficiency cohort, respectively (p=0.12).
Conclusion: Polymyxin B exposures in patients with normal and impaired renal function after receiving standard dosing of polymyxin B for at least 48 hours were comparable. Polymyxin B dosing adjustment in patients with renal insufficiency should be re-examined.
P. Manchandani, None
T. Ngamprasertchai, None
A. Boonyasiri, None
V. Tam, None
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