Polymyxin Acute Kidney Injury: Dosing and Other Strategies to Reduce Toxicity.

ABSTRACT: Polymyxins are valuable antimicrobials for the management of multidrug-resistant Gram-negative bacteria; however, nephrotoxicity associated with these drugs is a very common side effect that occurs during treatment. This article briefly reviews nephrotoxic mechanisms and risk factors for polymyxin-associated acute kidney injury (AKI) and discusses dosing strategies that may mitigate kidney damage without compromising antimicrobial activity. Polymyxins have a very narrow therapeutic window and patients requiring treatment with these drugs are frequently severely ill and have multiple comorbidities, which increases the risk of AKI. Notably, there is a significant overlap between therapeutic and toxic plasma polymyxin concentrations that substantially complicates dose selection. Recent dosing

SUBMITTER: Nation RL 

PROVIDER: S-EPMC6466603 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature