A Review of Polymyxin-B Dosage for Patients with Renal Impairment

Abstract

Since polymyxin B has a restricted therapeutic range and increased danger of both neurological damage and kidney damage, it is no longer the first choice for treating emerging gram-negative bacteria with multiple antibiotic resistance. The optimal dose schedule for patients with renal impairment regarding polymyxin B, it is provided as a chemically active formulation and primarily removed via methods other than kidney, is still up for debate. Similar to colistin, polymyxin-B effectively combats gram-negative aerobic bacterium that is resistant to several drugs such as Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli that produces carbapenemase, and Klebsiella pneumoniae. As a result, polymyxins cause cell apoptosis by inducing pan-caspase activation through many routes in a manner that is dependent on time and concentration. One of the most frequent and undesirable side effects of polymyxins is the development of AKI. A great deal of pharmacokinetic studies that have been published to far concur that creatinine clearance affects polymyxin B clearance; nevertheless, there is ongoing debate on the extent of this influence Keywords: Polymyxin-B, kidney damage, gram-negative bacterial infection, creatinine clearance.