2017
DOI: 10.1128/aac.02329-16
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Nephrotoxicity in Patients with or without Cystic Fibrosis Treated with Polymyxin B Compared to Colistin

Abstract: Nephrotoxicity is the primary adverse effect of the polymyxins. The relative rates of toxicity of polymyxin B and colistin have not been fully elucidated, especially in patients with cystic fibrosis (CF). A retrospective cohort study of adults treated with polymyxin B or colistin for at least 48 h was conducted. The primary endpoint was the incidence of kidney injury assessed by RIFLE (i.e., risk, injury, failure, loss, end-stage renal disease) criteria. Risk factors for kidney injury were evaluated using mult… Show more

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Cited by 36 publications
(37 citation statements)
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“…The risk of AKI appears to be less with polymyxin B, although some of the comparative studies are confounded by issues with different experimental designs . Therapeutic drug monitoring (TDM) is inherently more difficult for colistin because of the need to ensure that samples are collected in such a way as to minimize ongoing in vitro conversion of CMS to colistin.…”
Section: Clinical Questions and Recommendationsmentioning
confidence: 99%
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“…The risk of AKI appears to be less with polymyxin B, although some of the comparative studies are confounded by issues with different experimental designs . Therapeutic drug monitoring (TDM) is inherently more difficult for colistin because of the need to ensure that samples are collected in such a way as to minimize ongoing in vitro conversion of CMS to colistin.…”
Section: Clinical Questions and Recommendationsmentioning
confidence: 99%
“…Unfortunately, there is no way of knowing (a priori) the rate of in vivo conversion for a particular batch. The impact of a loading dose on the risk of developing AKI is unclear . Considering the need for timely antibiotic administration, the therapeutic benefits of a loading dose may justify the potential risk of AKI associated with loading dose .…”
Section: Clinical Questions and Recommendationsmentioning
confidence: 99%
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