biostudies-literatureHanafin PONIAID NIH HHSNational Institutes of HealthNIH HHS841-852https://www.ebi.ac.uk/biostudies/studies/S-EPMC12353974biostudies-literatureUnknown118(4)Polymyxins are used against highly resistant Gram-negative pathogens, and nephrotoxicity (acute kidney injury, AKI) is the major dose-limiting adverse effect. We aimed to develop a well-informed population pharmacokinetic/toxicodynamic (PK/TD) model using the largest polymyxin B-treated critically ill patient population studied to inform polymyxin B dosing strategies. Critically ill patients receiving intravenous polymyxin B for at least 48 hours were enrolled in an observational study. Serum creatinine (SCr) concentrations were collected from electronic medical records. PK/TD analysis and Monte Carlo simulations were performed to determine the probability of AKI, P(AKI), for clinically relevant treatments. Patients (N = 117) aged 18-94 received intravenous polymyxin B (1.33-6.00 mg/kg/dayClinical pharmacology and therapeuticsPopulation Pharmacokinetic/Toxicodynamic Model for Polymyxin B in Critically Ill Patients to Identify the Risk of Nephrotoxicity.PMC12353974R01 AI119446Bolon MPurcell AWLi JCherng BPZZavascki APNation RLKubin CJWang JKwa AShah JWang LYin MTMahadevan RKaye KSRao GGScheetz MHSandri AMHanafin POCalfee DPPogue JMfalsePopulation Pharmacokinetic/Toxicodynamic Model for Polymyxin B in Critically Ill Patients to Identify the Risk of Nephrotoxicity.Polymyxins are used against highly resistant Gram-negative pathogens, and nephrotoxicity (acute kidney injury, AKI) is the major dose-limiting adverse effect. We aimed to develop a well-informed population pharmacokinetic/toxicodynamic (PK/TD) model using the largest polymyxin B-treated critically ill patient population studied to inform polymyxin B dosing strategies. Critically ill patients receiving intravenous polymyxin B for at least 48 hours were enrolled in an observational study. Serum creatinine (SCr) concentrations were collected from electronic medical records. PK/TD analysis and Monte Carlo simulations were performed to determine the probability of AKI, P(AKI), for clinically relevant treatments. Patients (N = 117) aged 18-94 received intravenous polymyxin B (1.33-6.00 mg/kg/day2025-01-01T00:00:00Z2025 Oct2026-06-03T02:54:44.709Z2026-04-23T03:13:12.784ZS-EPMC123539744052437710.1002/cpt.3729