TDM-guided medication of polymyxin B in a patient with CRKP-induced bloodstream infection: a case report

Eur J Clin Microbiol Infect Dis. 2021 Jan;40(1):201-204. doi: 10.1007/s10096-020-03945-1. Epub 2020 Jul 13.

Abstract

The narrow therapeutic window of polymyxin B constrains its clinical use against the multidrug-resistant organisms (MDRO). A 45-year-old patient was suffering with bloodstream infection with high fever and received a combined treatment with polymyxin B and tigecycline. Therapeutic drug monitoring (TDM) was applied to polymyxin B to develop a personalized medication against MDRO. The dose adjustment of polymyxin B with TDM successfully alleviated the infection and reduced the incident of acute kidney injury as caused in case of the original doses of polymyxin B. TDM of polymyxin B represents a valid treatment to ensure the efficiency and safety.

Keywords: Acute kidney injury; Bloodstream infection; Carbapenem-resistant Klebsiella pneumoniae; Polymyxin B.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / complications
  • Bacteremia / diagnosis*
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Carbapenems
  • Diagnosis, Differential
  • Drug Administration Schedule
  • Drug Resistance, Bacterial*
  • Fever / etiology
  • Humans
  • Klebsiella Infections / complications
  • Klebsiella Infections / diagnosis*
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / isolation & purification*
  • Male
  • Middle Aged
  • Polymyxin B / administration & dosage
  • Polymyxin B / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Polymyxin B