Department of Pharmacy Services, Sinai-Grace Hospital, Detroit Medical Center, Detroit, MI, USA.
Department of Pharmacological and Pharmaceutical Sciences, Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Houston, TX, USA.
Adv Exp Med Biol. 2019;1145:289-304. doi: 10.1007/978-3-030-16373-0_17.
Polymyxin toxicity remains a significant concern that limits the clinical utility of this class of antibacterials for patient care. The most notable adverse event is the dose- and treatment-limiting nephrotoxicity that occurs in roughly 30-60% of patients receiving a systemic polymyxin. This chapter focuses on this adverse event with a detailed assessment of the incidence of, and risk factors for, polymyxin-associated nephrotoxicity. In particular, the text focuses on the impact of dose, serum concentrations, and polymyxin selection on nephrotoxicity. Additionally, less common, but clinically important adverse events are discussed.
多黏菌素类药物的毒性仍然是一个重大问题，限制了此类抗菌药物在患者治疗中的临床应用。最值得注意的不良事件是剂量和治疗受限的肾毒性，大约 30%-60%接受全身多黏菌素治疗的患者会发生这种情况。本章主要针对这一不良事件，详细评估多黏菌素相关性肾毒性的发生率和危险因素。特别是，文中重点讨论了剂量、血清浓度和多黏菌素选择对肾毒性的影响。此外，还讨论了一些不太常见但具有临床重要意义的不良事件。
