Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Journal of Clinical Microbiology & Infectious Diseases
Published in: European Journal of Clinical Microbiology & Infectious Diseases 1/2021

01-01-2021 | Acute Kidney Injury | Brief Report

TDM-guided medication of polymyxin B in a patient with CRKP-induced bloodstream infection: a case report

Authors: Xuben Yu, Jingye Pan, Ziye Zhou, Xin Wen, Ying Dai, Guanyang Lin, Zheng Jiao, Chunhong Zhang

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 1/2021

Login to get access

Abstract

The narrow therapeutic window of polymyxin B constrains its clinical use against the multidrug-resistant organisms (MDRO). A 45-year-old patient was suffering with bloodstream infection with high fever and received a combined treatment with polymyxin B and tigecycline. Therapeutic drug monitoring (TDM) was applied to polymyxin B to develop a personalized medication against MDRO. The dose adjustment of polymyxin B with TDM successfully alleviated the infection and reduced the incident of acute kidney injury as caused in case of the original doses of polymyxin B. TDM of polymyxin B represents a valid treatment to ensure the efficiency and safety.
Literature
1.
Munoz-Price LS, Poirel L, Bonomo RA et al (2013) Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. Lancet Infect Dis 13(9):785–796CrossRef
2.
van Duin D, Perez F, Rudin SD et al (2014) Surveillance of Carbapenem-resistant Klebsiella pneumoniae: tracking molecular epidemiology and outcomes through a regional network. Antimicrob Agents Chemother 58(7):4035–4041CrossRef
3.
van Duin D, Kaye KS, Neuner EA, Bonomo RA (2013) Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes. Diagn Microbiol Infect Dis 75(2):115–120CrossRef
4.
Ryan KJ, Schainuck LI, Hickman RO, Striker GE (1969) Colistimethate toxicity. Report of a fatal case in a previously healthy child. JAMA 207(11):2099–2101CrossRef
5.
Koch-Weser J, Sidel VW, Federman EB et al (1970) Adverse effects of sodium colistimethate. Manifestations and specific reaction rates during 317 courses of therapy. Ann Intern Med 72(6):857–868CrossRef
6.
Li J, Nation RL, Turnidge JD, Milne RW et al (2006) Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections. Lancet Infect Dis 6(9):589–601CrossRef
7.
Zavascki AP, Goldani LZ, Li J, Nation RL (2007) Polymyxin B for the treatment of multidrug-resistant pathogens: a critical review. J Antimicrob Chemother 60(6):1206–1215CrossRef
8.
Falagas ME, Kasiakou SK (2005) Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 40(9):1333–1341CrossRef
9.
Landman D, Georgescu C, Martin DA, Quale J (2008) Polymyxins revisited. Clin Microbiol Rev 21(3):449–465CrossRef
10.
Tumbarello M, Viale P, Viscoli C et al (2012) Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae Carbapenemase-producing K. pneumoniae: importance of combination therapy. Clin Infect Dis 55(7):943–950CrossRef
11.
Nation RL, Garonzik SM, Thamlikitkul V et al (2017) Dosing guidance for intravenous colistin in critically-ill patients. Clin Infect Dis 64:565–571PubMed
12.
Sandri AM, Landersdorfer CB, Jacob J et al (2013) Population pharmacokinetics of intravenous polymyxin B in critically ill patients: implications for selection of dosage regimens. Clin Infect Dis 57:524–531CrossRef
13.
Meng M, Wang L, Liu S et al (2016) Simultaneous quantitation of polymyxin B1, polymyxin B2 and polymyxin B1-1 in human plasma and treated human urine using solid phase extraction and liquid chromatography-tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 1012-1013:23–36CrossRef
14.
Tsuji BT, Pogue JM, Zavascki AP et al (2019) International consensus guidelines for the optimal use of the polymyxins: endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti-infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP). Pharmacotherapy. 39:10–39CrossRef
15.
Li J, Coulthard K, Milne R et al (2003) Steady-state pharmacokinetics of intravenous colistin methanesulfonate in patients with cystic fibrosis. J Antimicrob Chemother 52:987–992CrossRef
16.
Mehrotra R, De Gaudio R, Palazzo M (2004) Antibiotic pharmacokinetic and pharmacodynamic considerations in critical illness. Intensive Care Med 30:2145–2156CrossRef
17.
Elias LS, Konzen D, Krebs JM, Zavascki AP (2010) The impact of polymyxin B on in-hospital mortality of patients treated with this antibiotic. J Antimicrob Chemother 65:2231–2237CrossRef
18.
Rigatto MH, Behle TF, Falci DR et al (2015) Risk factors for acute kidney injury (AKI) in patients treated with polymyxin B and influence of AKI on mortality: a multicentre prospective cohort study. J Antimicrob Chemother 5:1552–1557CrossRef
Metadata
Title
TDM-guided medication of polymyxin B in a patient with CRKP-induced bloodstream infection: a case report
Authors
Xuben Yu
Jingye Pan
Ziye Zhou
Xin Wen
Ying Dai
Guanyang Lin
Zheng Jiao
Chunhong Zhang
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 1/2021
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-020-03945-1

Other articles of this Issue 1/2021

European Journal of Clinical Microbiology & Infectious Diseases 1/2021 Go to the issue

Original Article

Neutrophil extracellular traps may have a dual role in Pseudomonas aeruginosa keratitis

Original Article

High reproducibility of the interferon-gamma release assay T-SPOT.TB in serial testing

Original Article

Pharmacological inhibition of poly (ADP-ribose) polymerase by olaparib ameliorates influenza-virus-induced pneumonia in mice

Original Article

Rapid identification and antimicrobial susceptibility testing of Gram-negative rod on positive blood cultures using MicroScan panels

Review

Recurrence of SARS-CoV-2 viral RNA in recovered COVID-19 patients: a narrative review

Original Article

Persistence of group B Streptococcus vaginal colonization and prevalence of hypervirulent CC-17 clone correlate with the country of birth: a prospective 3-month follow-up cohort study
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits