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VOLUME 17 , ISSUE 5 ( October, 2013 ) > List of Articles

RESEARCH ARTICLE

To study the clinical efficacy and nephrotoxicity along with the risk factors for acute kidney injury associated with parenteral polymyxin B

Amit Kumar Mandal, Ruchika Nandha, Kavita Sekhri

Keywords : Acinetobacter baumannii, acute kidney injury, multidrug resistance gram −ve septicemia, nephrotoxicity, polymyxin B

Citation Information : Mandal AK, Nandha R, Sekhri K. To study the clinical efficacy and nephrotoxicity along with the risk factors for acute kidney injury associated with parenteral polymyxin B. Indian J Crit Care Med 2013; 17 (5):283-287.

DOI: 10.4103/0972-5229.120319

License: CC BY-ND 3.0

Published Online: 01-10-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim : The aim of this study was to evaluate the clinical efficacy and nephrotoxicity along with the risk factors for acute kidney injury (AKI) associated with the parenteral polymyxin B in patients with the multidrug resistance (MDR) gram −ve infections in a tertiary Intensive care unit (ICU). Materials and Methods : A retrospective cohort study (March 2010-October 2011) was conducted in Medical ICU of a 23 bedded tertiary care hospital in Northern India. Results : Out of 71 ICU patients who were administered polymyxin B, only 32 (M:F = 1:0.8) met the inclusion criteria. Patients with concurrent administration of nephrotoxic drugs were excluded from the study. Mean age of patients was 48.53 ± 13.90 years ranging from 16 years to 68 years. 6 out of 32 (18.7%) patients progressed to AKI, whereas renal functions remained normal in 26 (81.2%) patients. No statistically significant difference was observed in mortality between AKI and non AKI patients at the end of therapy (33.3% vs. 26.9%, P value 0.756). Older age (62.33 ± 11.90 vs. 45.34 ± 2.45, P value 0.005) was found to be an independent risk factor for causing nephrotoxicity. Conclusion : In the present scenario of rising infections with MDR gram −ve micro-organisms, this pilot study suggests that polymyxin B can be used effectively and safely in patients not receiving other nephrotoxic drugs, with cautious administration in older patients as they are more vulnerable to nephrotoxicity caused by polymyxin B.


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