Abstract:Objective To observe the efficacy and adverse reactions of polymyxin B in the treatment of elderly patients with hospital-acquired pneumonia due to multidrug-resistant (MDR) and pan-drug-resistant (XDR) bacteria. Methods To retrospectively analyze 117 elderly patients with hospital-acquired pneumonia due to MDR and XDR bacteria treated with intravenous polymyxin B admitted to the Department of Geriatrics and the Department of Respiratory and Critical Care Medicine of the Second Xiangya Hospital of Central South University from January 2018 to March 2023, to collect the clinical data, and to classify them into effective and ineffective groups according to the effect of the clinical treatments, and to analyze the factors influencing the efficacy of elderly patients with polymyxin B by logistic regression. Pneumonia patients' efficacy; according to whether acute kidney injury (AKI) occurred after polymyxin B treatment was divided into AKI group and no AKI group, logistic regression was used to analyze the influencing factors of AKI. Results 117 patients, mean age (74.4±8.9) years old, 53 cases were treated effectively, with an effective rate of 45.3%. High Acute Physiology and Chronic Health Status Scoring System II (APACHE II) score, Acinetobacter baumannii infection, use of vasoactive drugs, and polymyxin B regimen of <7 d were the influencing factors for poor outcome. Adverse effects were mainly renal injury (43 cases), and the incidence of AKI was 36.8%. High APACHE II score, polymyxin B daily dose ≥150 mg, and basal blood creatinine value were risk factors for the development of AKI after polymyxin B treatment. Conclusion Adequate dosing can improve the efficiency of polymyxin B treatment in elderly patients with pneumonia, and polymyxin B daily dose ≥150 mg increases the risk of renal injury.
Su Jing, Liu Zhiqing, Yang Yue, Chen Lin. Observation of polymyxin B in the treatment of elderly patients with hospital-acquired pneumonia due to multidrug-resistant and pan-drug-resistant bacteria[J]. Zhongnan Pharmacology, 2023, 21 (09): 2487-2494.