Chinese consensus guidelines for therapeutic drug monitoring of polymyxin B, endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society

J Zhejiang Univ Sci B. 2023 Feb 15;24(2):130-142. doi: 10.1631/jzus.B2200466.
[Article in English, Chinese]

Abstract

Polymyxin B, which is a last-line antibiotic for extensively drug-resistant Gram-negative bacterial infections, became available in China in Dec. 2017. As dose adjustments are based solely on clinical experience of risk toxicity, treatment failure, and emergence of resistance, there is an urgent clinical need to perform therapeutic drug monitoring (TDM) to optimize the use of polymyxin B. It is thus necessary to standardize operating procedures to ensure the accuracy of TDM and provide evidence for their rational use. We report a consensus on TDM guidelines for polymyxin B, as endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society. The consensus panel was composed of clinicians, pharmacists, and microbiologists from different provinces in China and Australia who made recommendations regarding target concentrations, sample collection, reporting, and explanation of TDM results. The guidelines provide the first-ever consensus on conducting TDM of polymyxin B, and are intended to guide optimal clinical use.

多黏菌素B是治疗广泛耐药革兰氏阴性细菌感染的最后“一道防线”,但因剂量限制性肾毒性及低剂量可能出现治疗失败和耐药性,临床上迫切需要通过治疗药物监测(TDM)优化其使用。多黏菌素B TDM专家共识以及规范操作程序的制定将有助于确保TDM的准确性并为其合理使用提供依据。中国药理学学会治疗药物监测研究专业委员会及上海医学会感染与化疗专科分会共同发起制定多黏菌素B的TDM专家共识。共识小组由来自中国不同省份的临床药学、临床医学和临床微生物学专家,及两位澳大利亚莫纳什大学专家组成,就多黏菌素B进行TDM的目标浓度、样本采集、测定、报告和TDM结果解释提出了建议。该指南共识的制定旨在指导多黏菌素B的个体化精准治疗。.

多黏菌素B是治疗广泛耐药革兰氏阴性细菌感染的最后“一道防线”,但因剂量限制性肾毒性及低剂量可能出现治疗失败和耐药性,临床上迫切需要通过治疗药物监测(TDM)优化其使用。多黏菌素B TDM专家共识以及规范操作程序的制定将有助于确保TDM的准确性并为其合理使用提供依据。中国药理学学会治疗药物监测研究专业委员会及上海医学会感染与化疗专科分会共同发起制定多黏菌素B的TDM专家共识。共识小组由来自中国不同省份的临床药学、临床医学和临床微生物学专家,及两位澳大利亚莫纳什大学专家组成,就多黏菌素B进行TDM的目标浓度、样本采集、测定、报告和TDM结果解释提出了建议。该指南共识的制定旨在指导多黏菌素B的个体化精准治疗。

Keywords: Clinical efficacy; Pharmacokinetics; Polymyxin B; Therapeutic drug monitoring (TDM).

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • China
  • Drug Monitoring* / methods
  • Humans
  • Polymyxin B*
  • Practice Guidelines as Topic

Substances

  • Anti-Bacterial Agents
  • Polymyxin B