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Assessment of polymyxin B associated nephrotoxicity in ICU patients in a Malaysian tertiary teaching hospital
Lim, M. Y1, Nusaibah Abdul Rahim2, Periyasamy, P3, Lau, C. L4.
Introduction: Polymyxins are used as the “last-line therapy” for multi drug resistant (MDR) Gram-negative bacterial infections. However, the development of nephrotoxicity is a major concern. The objectives of this study were to determine the incidence and severity of acute kidney injury (AKI) and to identify risk factors associated with AKI and mortality rate in Malaysian patients on polymyxin B (PMB) for MDR Gram-negative bacterial infections. Methods: A retrospective study was conducted in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Medical and
medication charts were reviewed for all intensive care unit (ICU) patients who received intravenous (IV) PMB from 1st May 2008 to 1st May 2018. Simple and multiple logistic regression were performed to identify risk factors of PMB induced nephrotoxicity. Results: Among the total 572 patients identified, only 31 patients were eligible to be included. The incidence rate of AKI was 45.2% (14 of 31 patients). Univariate analysis showed that age was a significant risk factor of PMB associated nephrotoxicity [OR 1.074; 95% CI 1.002-1.151; P=0.045]. Other four variables (P<0.2) included were female, baseline serum creatinine, baseline estimated glomerular filtration rate (eGFR) and diabetes mellitus. Further analysis by multiple logistics regression showed that age was the variable independently associated
with the development of AKI (OR 1.109; 95% CI 1.007-1.221; P=0.035). Furthermore, the development of AKI was not significantly associated with mortality rate. The incidence, severity, risk factor for PMB associated nephrotoxicity and mortality rate of Malaysian ICU patients on PMB were identified. Conclusion: PMB may beused as the salvage therapy of nosocomial infections with extra caution and close monitoring especially in the elderly. Future studies,
involving more centers are needed to provide further information regarding PMB induced nephrotoxicity in Malaysian ICU patients.
Affiliation:
- Taylor's University, Malaysia
- Taylor's University, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
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Indexation |
Indexed by |
MyJurnal (2021) |
H-Index
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3 |
Immediacy Index
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0.000 |
Rank |
0 |
Indexed by |
Scopus 2020 |
Impact Factor
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CiteScore (0.2) |
Rank |
Q4 (Medicine (all)) |
Additional Information |
SJR (0.144) |
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