医学
神经毒性
多粘菌素B
多粘菌素
优势比
不利影响
毒性
肾毒性
入射(几何)
内科学
肾移植
置信区间
风险因素
胃肠病学
移植
药理学
外科
抗生素
物理
光学
微生物学
生物
作者
Ye Zhou,Ying Liu,Xubiao Xie,Lei Song,Gongbin Lan,Bin Sun,Tiantian Tang,Han Yan,Bikui Zhang,Ping Xu
摘要
Background Toxicity is a major concern related to the clinical use of polymyxin B, and available safety data for renal transplant patients are limited. Aims We investigated the safety of polymyxin B and toxicity risk factors in renal transplant patients. Methods A prospective study was performed on a group of renal transplant patients who received intravenous polymyxin B between January 2018 and August 2021. Polymyxin B treatment was monitored to evaluate toxicity and risk factors. Results A total of 235 courses of polymyxin B were administered to 213 patients. Of these, 121 (51.5%) developed skin hyperpigmentation (SH), 149 (63.4%) developed neurotoxicity and 10 (5.5%) developed acute kidney injury of which 80% was reversible. Risk factors for developing SH included a high total dose by weight (odds ration [OR] 1.31, 95% confidence interval [CI] 1.08–1.60, P = .008) and the presence of neurotoxicity (OR 2.86, 95% CI 1.56–5.26, P = .001). Neurotoxicity manifested during the first 2 days of treatment. Neurotoxicity occurred most commonly in women (OR 3.84, 95% CI 1.82–8.10, P < .0001), and the presence of SH (OR 1.98, 95% CI 1.13–3.46, P = .016) was also an independent risk factor. Conclusions Neurotoxicity and SH are the two major adverse effects of polymyxin B in renal transplant patients, which may limit its clinical use.
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