Dose-Related Clinical Efficacy of Polymyxin B in a Critically Ill Patient

Abstract

Published dosing schemes call for reduced dosage of polymyxin B for patients with renal insufficiency. However, recent evidence suggests that clearance of polymyxin B is not affected by renal function. We report a patient with renal insufficiency who had microbiological failure when adjusted dosing was administered but clearance of bacteremia when the dose was increased to that recommended for a patient with normal renal function.

In Brief

Even though polymyxins are being used more commonly with the emergence of resistant gram negative bacteria, appropriate dosing of Polymyxin B especially in patients with renal insufficiency remains unknown. This reported case indicates that dosage of polymyxin B adjusted for renal insufficiency may be inadequate.