Journal of Shandong University (Health Sciences) ›› 2024, Vol. 62 ›› Issue (7): 72-77.doi: 10.6040/j.issn.1671-7554.0.2024.0040

• 临床医学 • Previous Articles     Next Articles

Clinical efficacy of polymyxin B in treatment of patients infected with carbapenem resistant Gram-negative bacteria in intensive care unit

SUN Xiaodan, YANG Chuang   

  1. Intensive Care Unit, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2024-09-20

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Abstract: Objective To investigate the efficacy and safety of intravenous polymyxin B in the treatment of patients infected with carbapenem-resistant gram-negative bacteria in intensive care unit(ICU). Methods Clinical data of 69 hospitalized patients diagnosed with carbapenem-resistant Gram-negative bacillus infections and treated with intravenous polymyxin B during their hospitalization in the ICU of The Second Hospital of Shandong University from January 2022 to December 2023 were retrospectively analyzed. According to their clinical outcomes, the patients were divided into clinically effective group and clinically ineffective group, and the general data, clinical efficacy and safety of the drugs were analyzed. The statistically significant variables were subjected to Logistic regression to explore the factors affecting the efficacy of polymyxin B. Results There were no significant differences in age, sex, type of drug-resistant bacteria, use of continuous renal replacement therapy, white blood cell, procalcitonin, and bilirubin before treatment between the clinically effective group and the clinically ineffective group. The treatment time of clinically effective group was longer than that of clinically ineffective group(P<0.05). The acute physiology and chronic health evaluation II(APACHEII)score of the clinically effective group was lower than that of the clinically ineffective group(P<0.05). More patients in the clinically ineffective group were treated with mechanical ventilation and vasoactive drugs(both P<0.05). The difference of interleukin-6, creatinine, urea nitrogen, and estimated glomerular filtration rate before treatment between the two groups were statistically significant(P<0.05). Logistic regression analysis showed whether vasoactive drugs were used(β=-0.256,OR=0.128,95%CI: 0.029-0.574,P=0.007)and APACHEII score at ICU admission(β=-1.515, OR=0.220,95%CI: 0.060-0.809,P=0.023)were independently correlated with clinical efficacy. The proportion of liver injury was 20.83%(10/48). Conclusion Polymyxin B has a good therapeutic effect on hospital-acquired infections caused by multidrug-resistant Gram-negative bacteria. APACHEII score at ICU admission and vasoactive drug are independent factors related to the clinical efficacy of polymyxin B.

Key words: Polymyxin B, Carbapenem-resistant Gram-negative bacteria, Intensive care unit, Clinical efficacy, Safety

CLC Number: 

  • R574
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