In order to provide an idea dose of
polymyxin B in Chinese patients with renal impairment, the present study collected the clinical data of all patients with renal impairment who received
polymyxin B therapy in the intensive care unit (ICU) of The First Affiliated Hospital of Bengbu Medical College (Bengbu, China). The clinical data of six patients treated in the ICU between February 2018 and May 2019 were retrospectively analyzed. All patients had renal impairment and were treated with
polymyxin B combination
therapy. The patients in the current study received
polymyxin B and
carbapenem, or
polymyxin,
carbapenem,
cefoperazon and
sulbactam, or
polymyxin B,
carbapenems and
aminoglycoside treatment. One patient discontinued treatment. The other five patients received
polymyxin B at a dosage of 50 mg every 12 h (100 mg/day) through an
intravenous drip. During treatment, four of the five patients had deteriorating renal function to varying degrees, and
continuous renal replacement therapy (CRRT) was initiated.
Polymyxin B was discontinued in all patients when the
infection was controlled.
After treatment, four of five patients showed improvement in renal function, and had normal kidney function at the 1-month follow-up evaluation, whereas one patient had
chronic renal disease. During hospitalization, one patient experienced neurotoxicity, showing decreased limb muscle strength and
cognitive impairment, which might have been caused by
polymyxin B, according to the Naranjo
adverse drug reactions probability scale (also known as the Naranjo algorithm) score. The present report demonstrated that the administration of 100 mg daily dosage of
polymyxin B to the five patients weighing between 50 and 75 kg, could control pulmonary
infection during the course of treatment of Chinese patients with renal impairment, however, further research is needed to verify this result. Risk factors for nephrotoxicity and neurotoxicity need to be fully assessed before initiating
polymyxin B therapy in patients with renal impairment.