Research progress in pharmacokinetics/pharmacodynamics and nephrotoxicity of polymyxin B / 中国药理学与毒理学杂志

ABSTRACT

In recent years, polymyxin B has played an important role in the salvage treatment of Gram-negative bacterial infections involving multi-drug-resistant bacteria and pan-drug-resistant bacteria. Its clinical value has been re-studied. However, it is difficult to use this antibitotoxin accurately under its potential nephrotoxicity and empirical administration, which restricts its rational use in clinic. In this paper, the pharmacokinetics and pharmacodynamics of polymyxin B, the mechanism of nephrotoxicity and the risk factors affecting nephrotoxicity were analyzed. It was possible that polymyxin B was mainly eliminated through the non-renal pathway. Clinically, loading doses are required for patients with severe infection. The incidence of nephrotoxicity can be reduced by controlling other covariates, and polymyxin B-induced nephrotoxicity involves the mitochondrial pathway and cell death receptor pathway. This paper is expected to provide reference for the clinical rational use of polymyxin B.