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.
概要
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Avedissian SN, Miglis C, Kubin CJ, et al., 2018. Polymyxin B pharmacokinetics in adult cystic fibrosis patients. Pharmacotherapy, 38(7):730–738. https://doi.org/10.1002/phar.2129
Azad MAK, Nation RL, Velkov T, et al., 2019. Mechanisms of polymyxin-induced nephrotoxicity. In: Li J, Nation RL, Kaye KS (Eds.), Polymyxin Antibiotics: From Laboratory Bench to Bedside. Springer, Cham, p.305–319. https://doi.org/10.1007/978-3-030-16373-0_18
Begg EJ, Barclay ML, Duffull SB, 1995. A suggested approach to once-daily aminoglycoside dosing. Br J Clin Pharmacol, 39(6):605–609. https://doi.org/10.1111/j.1365-2125.1995.tb05719.x
Behzadi P, Baráth Z, Gajdács M, 2021. It’s not easy being green: a narrative review on the microbiology, virulence and therapeutic prospects of multidrug-resistant Pseudomonas aeruginosa. Antibiotics, 10(1):42. https://doi.org/10.3390/antibiotics10010042
Bergen PJ, Bulitta JB, Forrest A, et al., 2010. Pharmacokinetic/pharmacodynamic investigation of colistin against Pseudomonas aeruginosa using an in vitro model. Antimicrob Agents Chemother, 54(9):3783–3789. https://doi.org/10.1128/AAC.00903-09
Bergen PJ, Forrest A, Bulitta JB, et al., 2011a. Clinically relevant plasma concentrations of colistin in combination with imipenem enhance pharmacodynamic activity against multidrug-resistant Pseudomonas aeruginosa at multiple inocula. Antimicrob Agents Chemother, 55(11):5134–5142. https://doi.org/10.1128/AAC.05028-11
Bergen PJ, Tsuji BT, Bulitta JB, et al., 2011b. Synergistic killing of multidrug-resistant Pseudomonas aeruginosa at multiple inocula by colistin combined with doripenem in an in vitro pharmacokinetic/pharmacodynamic model. Antimicrob Agents Chemother, 55(12):5685–5695. https://doi.org/10.1128/AAC.05298-11
Bielecka-Oder A, 2018. Safety and security regulations against biological threats. In: Radosavljevic V, Banjari I, Belojevic G (Eds.), Defence Against Bioterrorism: Methods for Prevention and Control. Springer, Dordrecht, p. 151–176. https://doi.org/10.1007/978-94-024-1263-5_12
Bulitta JB, Yang JC, Yohonn L, et al., 2010. Attenuation of colistin bactericidal activity by high inoculum of Pseudomonas aeruginosa characterized by a new mechanism-based population pharmacodynamic model. Antimicrob Agents Chemother, 54(5):2051–2062. https://doi.org/10.1128/AAC.00881-09
Burkin MA, Galvidis IA, Surovoy YA, et al., 2021. Development of ELISA formats for polymyxin B monitoring in serum of critically ill patients. J Pharm Biomed Anal, 204: 114275. https://doi.org/10.1016/j.jpba.2021.114275
Cai YY, Lee W, Kwa AL, 2015. Polymyxin B versus colistin: an update. Expert Rev Anti-Infect Ther, 13(12): 1481–1497. https://doi.org/10.1586/14787210.2015.1093933
CDC, 2019. Antibiotic Resistance Threats in the United States. CDC, Atlanta, USA.
Cheah SE, Wang JP, Nguyen VTT, et al., 2015. New pharmacokinetic/pharmacodynamic studies of systemically administered colistin against Pseudomonas aeruginosa and Acinetobacter baumannii in mouse thigh and lung infection models: smaller response in lung infection. J Antimicrob Chemother, 70(12):3291–3297. https://doi.org/10.1093/jac/dkv267
Chen N, Guo JH, Xie J, et al., 2022. Population pharmacokinetics of polymyxin B: a systematic review. Ann Transl Med, 10(4):231. https://doi.org/10.21037/atm-22-236
Chen WQ, Liu HF, Wang QL, et al., 2021. Estimation of the area under concentration-time curve of polymyxin B based on limited sampling concentrations in Chinese patients with severe pneumonia. Eur J Clin Pharmacol, 77(1):95–105. https://doi.org/10.1007/s00228-020-02986-x
Chinese Pharmacopoeia Commission, 2020. 9012 Guidelines for Validation of Quantitative Analysis Methods for Biological Samples. China Medical Science Press, Beijing, China, p.466–472 (in Chinese).
Ciftci A, Izdes S, Altintas ND, 2018. Factors determining nephrotoxicity and mortality in critical care patients receiving colistin. J Infect Dev Ctries, 11(12):912–918. https://doi.org/10.3855/jidc.9443
Covelli J, Ruszaj D, Straubinger R, et al., 2017. The development and validation of a simple liquid chromatographytandem mass spectrometry method for polymyxin B1 and B2 quantification in different matrices. J Chromatogr B, 1065–1066:112–118. https://doi.org/10.1016/j.jchromb.2017.09.031
de Velde F, Mouton JW, de Winter BCM, et al., 2018. Clinical applications of population pharmacokinetic models of antibiotics: challenges and perspectives. Pharmacol Res, 134: 280–288. https://doi.org/10.1016/j.phrs.2018.07.005
Deng Y, Xu B, Li X, et al., 2021. Exploration of LC-MS/MS method for therapeutic drug monitoring and clinical application of polymyxin B. Chin Pharm J, 56(15): 1249–1254 (in Chinese). https://doi.org/10.11669/cpj.2021.15.010
Deris ZZ, Yu HH, Davis K, et al., 2012. The combination of colistin and doripenem is synergistic against Klebsiella pneumoniae at multiple inocula and suppresses colistin resistance in an in vitro pharmacokinetic/pharmacodynamic model. Antimicrob Agents Chemother, 56(10):5103–5112. https://doi.org/10.1128/AAC.01064-12
Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society, 2019. The Expert Consensus on the Standards of Therapeutic Drug Monitoring (2019 Edition). Eval Anal Drug-Use Hosp China, 19(8):897–898, 902 (in Chinese). https://doi.org/10.14009/j.issn.1672-2124.2019.08.001
Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society, Hospital Pharmacy Committee of Chinese Pharmaceutical Association, Evidence-Based Pharmacy Committee of Chinese Pharmaceutical Association, et al., 2020. The Expert Consensus on the Interpretation of Therapeutic Drug Monitoring. Chin J Hosp Pharm, 40(23): 2389–2395 (in Chinese). https://doi.org/10.13286/j.1001-5213.2020.23.01
Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society, Pharmaceutical Bioanalysis Committee, China Pharmaceutical Association, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 2021. Expert Consensus on Quality Assurance of Chromatographic Technology for Therapeutic Drug Monitoring (2021 Edition). Chin Pharm J, 56(17):1443–1448 (in Chinese). https://doi.org/10.11669/cpj.2021.17.016
Dudhani RV, Turnidge JD, Nation RL, et al., 2010a. fAUC/MIC is the most predictive pharmacokinetic/pharmacodynamic index of colistin against Acinetobacter baumannii in murine thigh and lung infection models. J Antimicrob Chemother, 65(9):1984–1990. https://doi.org/10.1093/jac/dkq226
Dudhani RV, Turnidge JD, Coulthard K, et al., 2010b. Elucidation of the pharmacokinetic/pharmacodynamic determinant of colistin activity against Pseudomonas aeruginosa in murine thigh and lung infection models. Antimicrob Agents Chemother, 54(3):1117–1124. https://doi.org/10.1128/AAC.01114-09
Duggan JX, 2019. Quantification below the LLOQ in regulated LC-MS/MS assays: a review of bioanalytical considerations and cautions. Bioanalysis, 11(8):797–814. https://doi.org/10.4155/bio-2018-0261
Fratoni AJ, Nicolau DP, Kuti JL, 2021. A guide to therapeutic drug monitoring of β-lactam antibiotics. Pharmacotherapy, 41(2):220–233. https://doi.org/10.1002/phar.2505
Furey A, Moriarty M, Bane V, et al., 2013. Ion suppression; A critical review on causes, evaluation, prevention and applications. Talanta, 115:104–122. https://doi.org/10.1016/j.talanta.2013.03.048
Gales AC, Castanheira M, Jones RN, et al., 2012. Antimicrobial resistance among Gram-negative bacilli isolated from Latin America: results from SENTRY Antimicrobial Surveillance Program (Latin America, 2008–2010). Diagn Microbiol Infect Dis, 73(4):354–360. https://doi.org/10.1016/j.diagmicrobio.2012.04.007
Gul S, Kuscu F, Aydemir H, et al., 2016. Risk factors for colistin-associated acute kidney injury: a multicenter study from Turkey. Jpn J Infect Dis, 69(2):109–112. https://doi.org/10.7883/yoken.JJID.2014.501
Hermes DM, Pitt CP, Lutz L, et al., 2013. Evaluation of heteroresistance to polymyxin B among carbapenem-susceptible and -resistant Pseudomonas aeruginosa. J Med Microbiol, 62(8):1184–1189. https://doi.org/10.1099/jmm.0.059220-0
Javan AO, Shokouhi S, Sahraei Z, 2015. A review on colistin nephrotoxicity. Eur J Clin Pharmacol, 71(7):801–810. https://doi.org/10.1007/s00228-015-1865-4
Jia XD, Guo CH, Yin Z, et al., 2022. Risk factors for acute kidney injury induced by intravenous polymyxin B in Chinese patients with severe infection. Infect Drug Resist, 15:1957–1965. https://doi.org/10.2147/IDR.S363944
Jones RN, Guzman-Blanco M, Gales AC, et al., 2013. Susceptibility rates in Latin American nations: report from a regional resistance surveillance program (2011). Braz J Infect Dis, 17(6):672–681. https://doi.org/10.1016/j.bjid.2013.07.002
Kubin CJ, Nelson BC, Miglis C, et al., 2018. Population pharma-cokinetics of intravenous polymyxin B from clinical samples. Antimicrob Agents Chemother, 62(3):e01493–17. https://doi.org/10.1128/aac.01493-17
Lakota EA, Landersdorfer CB, Nation RL, et al., 2018. Personalizing polymyxin B dosing using an adaptive feedback control algorithm. Antimicrob Agents Chemother, 62(7): e00483–18. https://doi.org/10.1128/AAC.00483-18
Lanckohr C, Boeing C, de Waele JJ, et al., 2021. Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A-TEAMICU survey. Ann Intensive Care, 11:131. https://doi.org/10.1186/s13613-021-00917-2
Landersdorfer CB, Wang JP, Wirth V, et al., 2018. Pharmacokinetics/pharmacodynamics of systemically administered polymyxin B against Klebsiella pneumoniae in mouse thigh and lung infection models. J Antimicrob Chemother, 73(2):462–468. https://doi.org/10.1093/jac/dkx409
Li J, Turnidge J, Milne R, et al., 2001. In vitro pharmacodynamic properties of colistin and colistin methanesulfonate against Pseudomonas aeruginosa isolates from patients with cystic fibrosis. Antimicrob Agents Chemother, 45(3): 781–785. https://doi.org/10.1128/AAC.45.3.781-785.2001
Li J, Nation RL, Turnidge JD, et al., 2006. Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections. Lancet Infect Dis, 6(9):589–601. https://doi.org/10.1016/S1473-3099(06)70580-1
Li YQ, Chen KF, Ding JJ, et al., 2021. External evaluation of published population pharmacokinetic models of polymyxin B. Eur J Clin Pharmacol, 77(12):1909–1917. https://doi.org/10.1007/s00228-021-03193-y
Liu XF, Yu ZW, Wang Y, et al., 2020. Therapeutic drug monitoring of polymyxin B by LC-MS/MS in plasma and urine. Bioanalysis, 12(12):845–855. https://doi.org/10.4155/bio-2020-0051
Liu XF, Chen YC, Yang HJ, et al., 2021. Acute toxicity is a dose-limiting factor for intravenous polymyxin B: a safety and pharmacokinetic study in healthy Chinese subjects. J Infect, 82(2):207–215. https://doi.org/10.1016/j.jinf.2021.01.006
Lunn DJ, Best N, Thomas A, et al., 2002. Bayesian analysis of population PK/PD models: general concepts and software. J Pharmacokinet Pharmacodyn, 29(3):271–307. https://doi.org/10.1023/a:1020206907668
Manchandani P, Thamlikitkul V, Dubrovskaya Y, et al., 2018. Population pharmacokinetics of polymyxin B. Clin Pharmacol Ther, 104(3):534–538. https://doi.org/10.1002/cpt.981
Meng M, Wang LX, Liu S, et al., 2016. Simultaneous quantitation of polymyxin B1, polymyxin B2 and polymyxin B1-1 in human plasma and treated human urine using solid phase extraction and liquid chromatography-tandem mass spectrometry. J Chromatogr B, 1012–1013:23–36. https://doi.org/10.1016/j.jchromb.2016.01.013
Miglis C, Rhodes NJ, Avedissian SN, et al., 2018. Population pharmacokinetics of polymyxin B in acutely ill adult patients. Antimicrob Agents Chemother, 62(3):e01475–17. https://doi.org/10.1128/aac.01475-17
Naesens M, Kuypers DRJ, Sarwal M, 2009. Calcineurin inhibitor nephrotoxicity. Clin J Am Soc Nephrol, 4(2):481–508. https://doi.org/10.2215/CJN.04800908
Nang SC, Azad MAK, Velkov T, et al., 2021. Rescuing the last-line polymyxins: achievements and challenges. Pharmacol Rev, 73(2):679–728. https://doi.org/10.1124/pharmrev.120.000020
Olaitan AO, Morand S, Rolain JM, 2014. Mechanisms of polymyxin resistance: acquired and intrinsic resistance in bacteria. Front Microbiol, 5:643. https://doi.org/10.3389/fmicb.2014.00643
Pai MP, Neely M, Rodvold KA, et al., 2014. Innovative approaches to optimizing the delivery of vancomycin in individual patients. Adv Drug Deliv Rev, 77:50–57. https://doi.org/10.1016/j.addr.2014.05.016
Panuwet P, Hunter RE, D’Souza PE, et al., 2016. Biological matrix effects in quantitative tandem mass spectrometry-based analytical methods: advancing biomonitoring. Crit Rev Anal Chem, 46(2):93–105. https://doi.org/10.1080/10408347.2014.980775
Phe K, Lee Y, McDaneld PM, et al., 2014. In vitro assessment and multicenter cohort study of comparative nephrotoxicity rates associated with colistimethate versus polymyxin B therapy. Antimicrob Agents Chemother, 58(5): 2740–2746. https://doi.org/10.1128/AAC.02476-13
Pogue JM, Tam VH, 2019. Toxicity in patients. In: Li J, Nation RL, Kaye KS (Eds.), Polymyxin Antibiotics: From Laboratory Bench to Bedside. Springer, Cham, p.289–304. https://doi.org/10.1007/978-3-030-16373-0_17
Pogue JM, Jones RN, Bradley JS, et al., 2020. Polymyxin susceptibility testing and interpretive breakpoints: recommendations from the United States Committee on Antimicrobial Susceptibility Testing (USCAST). Antimicrob Agents Chemother, 64(2):e01495–19. https://doi.org/10.1128/aac.01495-19
Roberts JA, Kirkpatrick CMJ, Lipman J, 2011. Monte Carlo simulations: maximizing antibiotic pharmacokinetic data to optimize clinical practice for critically ill patients. J Antimicrob Chemother, 66(2):227–231. https://doi.org/10.1093/jac/dkq449
Rybak MJ, Le J, Lodise TP, et al., 2020. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Am J Health Syst Pharm, 77(11):835–864. https://doi.org/10.1093/ajhp/zxaa036
Sandri AM, Landersdorfer CB, Jacob J, et al., 2013. Population pharmacokinetics of intravenous polymyxin B in critically ill patients: implications for selection of dosage regimens. Clin Infect Dis, 57(4):524–531. https://doi.org/10.1093/cid/cit334
Song FH, 2011. “Cross-talk” in scheduled multiple reaction monitoring caused by in-source fragmentation in herbicide screening with liquid chromatography electrospray tandem mass spectrometry. J Agric Food Chem, 59(9):4361–4364. https://doi.org/10.1021/jf200592n
Sun L, Chen WQ, Deng ZX, et al., 2009. Microbiological assay for quantitative determination of polyoxin B. Process Biochem, 44(3):361–364. https://doi.org/10.1016/j.procbio.2008.11.011
Tam VH, Schilling AN, Vo G, et al., 2005. Pharmacodynamics of polymyxin B against Pseudomonas aeruginosa. Antimicrob Agents Chemother, 49(9):3624–3630. https://doi.org/10.1128/AAC.49.9.3624-3630.2005
Tam VH, Lee LS, Ng TM, et al., 2020. Performance of population pharmacokinetic models in predicting polymyxin B exposures. Microorganisms, 8(11):1814. https://doi.org/10.3390/microorganisms8111814
Theuretzbacher U, Gottwalt S, Beyer P, et al., 2019. Analysis of the clinical antibacterial and antituberculosis pipeline. Lancet Infect Dis, 19(2):e40–e50. https://doi.org/10.1016/S1473-3099(18)30513-9
Thomas TA, Broun EC, Abildskov KM, et al., 2012. High performance liquid chromatography-mass spectrometry assay for polymyxin B1 and B2 in human plasma. Ther Drug Monit, 34(4):398–405. https://doi.org/10.1097/FTD.0b013e31825c827a
Tsuji BT, Pogue JM, Zavascki AP, et al., 2019. International consensus guidelines for the optimal use of the polymyxins: endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti-infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP). Pharmacotherapy, 39(1):10–39. https://doi.org/10.1002/phar.2209
Wang JS, Gao Y, Dorshorst DW, et al., 2017. Development of a multi-matrix LC-MS/MS method for urea quantitation and its application in human respiratory disease studies. J Pharm Biomed Anal, 133:96–104. https://doi.org/10.1016/j.jpba.2016.11.001
Wang PL, Zhang QW, Qin ZF, et al., 2020. A simple and robust liquid chromatography with tandem mass spectrometry analytical method for therapeutic drug monitoring of plasma and cerebrospinal fluid polymyxin B1 and B2. Ther Drug Monit, 42(5):716–723. https://doi.org/10.1097/FTD.0000000000000754
Wang PL, Zhang QW, Zhu ZF, et al., 2021. Comparing the population pharmacokinetics of and acute kidney injury due to polymyxin B in Chinese patients with or without renal insufficiency. Antimicrob Agents Chemother, 65(2): e01900–20. https://doi.org/10.1128/aac.01900-20
Wang PL, Xing H, Zhang F, et al., 2022. Population pharmacokinetics of polymyxin B in critically ill patients receiving continuous venovenous haemofiltration. Int J Antimicrob Agents, 60(1):106599. https://doi.org/10.1016/j.ijantimicag.2022.106599
Wen YX, Qu Q, Long WM, et al., 2022. Nephrotoxicity and efficacy assessment of polymyxin B use in renal transplant patients. Infect Drug Resist, 15:275–283. https://doi.org/10.2147/IDR.S348571
Wicha SG, Märtson AG, Nielsen EI, et al., 2021. From therapeutic drug monitoring to model-informed precision dosing for antibiotics. Clin Pharmacol Ther, 109(4):928–941. https://doi.org/10.1002/cpt.2202
Wong G, Sime FB, Lipman J, et al., 2014. How do we use therapeutic drug monitoring to improve outcomes from severe infections in critically ill patients? BMC Infect Dis, 14:288. https://doi.org/10.1186/1471-2334-14-288
Zavascki AP, Nation RL, 2017. Nephrotoxicity of polymyxins: is there any difference between colistimethate and polymyxin B? Antimicrob Agents Chemother, 61(3): e02319–16. https://doi.org/10.1128/aac.02319-16
Zavascki AP, Goldani LZ, Cao GY, et al., 2008. Pharmacokinetics of intravenous polymyxin B in critically ill patients. Clin Infect Dis, 47(10): 1298–1304. https://doi.org/10.1086/592577
Zhang XJ, Qi SY, Duan XG, et al., 2021. Clinical outcomes and safety of polymyxin B in the treatment of carbapenem-resistant Gram-negative bacterial infections: a real-world multicenter study. J Transl Med, 19(1):431. https://doi.org/10.1186/s12967-021-03111-x
Acknowledgments
This work was supported by the Shanghai Leading Talents Award, Shanghai Municipal Health Commission (No. LJ2016-01) and the Clinical Research Plan of Shanghai Hospital Development Center (No. SHDC2022CRW004). We thank Yalin DONG (the First Affiliated Hospital of Xi’an Jiaotong University), Zhanjun DONG (Hebei General Hospital), Dong LIU (Tongji Medical College of Huazhong University of Science and Technology), Maobai LIU (Fujian Medical University Union Hospital), Xuemei LUO (Nanjing Drum Tower Hospital), Xueyan LIU (Shenzhen People’s Hospital), Suiqin NI (Guangzhou First People’s Hospital), Qi PEI (the Third Xiangya Hospital of Central South University), Yi QIN (the First Affiliated Hospital of Soochow University), Jingwen WANG (Xijing Hospital), Li WEI (the First Affiliated Hospital of Guangzhou Medical University), Yanzhe XIA (the First Affiliated Hospital, Sun Yat-sen University), Hengjie YUAN (Tianjin Medical University General Hospital), Mingjie YU (the Southwest Hospital of Army Medical University), Qiwen YANG (Peking Union Medical College Hospital), Xiuling YANG (the Second Hospital of Hebei Medical University), Yuetian YU (Renji Hospital, School of Medicine, Shanghai Jiao Tong University), Chunhong ZHANG (the First Affiliated Hospital of Wenzhou Medical University), Kanghuai ZHANG (the Second Affiliated Hospital of Xi’ an Jiaotong University), Pengcheng ZHENG (the First People’s Hospital of Yunnan Province), Suodi ZHAI (Peking University Third Hospital), Xianglin ZHANG (China-Japan Friendship Hospital), and Xiaojian ZHANG (the First Affiliated Hospital of Zhengzhou University) for providing expert reviews and suggestions.
Author information
Authors and Affiliations
Contributions
Xiaofen LIU, Chenrong HUANG, and Phillip J. BERGEN wrote and edited the manuscript. Liyan MIAO and Jing ZHANG initiated the consensus. Jian LI, Jingjing ZHANG, Yijian CHEN, Yongchuan CHEN, Beining GUO, Fupin HU, Jinfang HU, Linlin HU, Xin LI, Hongqiang QIU, Hua SHAO, Tongwen SUN, Yu WANG, Ping XU, Jing YANG, Yong YANG, Zhenwei YU, Bikui ZHANG, Huaijun ZHU, Xiaocong ZUO, Yi ZHANG, Liyan MIAO, and Jing ZHANG were consensus panel. All authors have read and approved the final manuscript.
Corresponding authors
Ethics declarations
Jian LI licensed his new peptide antibiotics to Qpex Biopharma and has received research grants, speaking honoraria and consulting fees from Northern Antibiotics, Avexa, Genentech, Healcare, CTTQ, MedCom, Jiayou Medicine, Aosaikang, DanDi BioScience, and Qpex Biopharma. Xiaofen LIU, Chenrong HUANG, Phillip J. BERGEN, Jingjing ZHANG, Yijian CHEN, Yongchuan CHEN, Beining GUO, Fupin HU, Jinfang HU, Linlin HU, Xin LI, Hongqiang QIU, Hua SHAO, Tongwen SUN, Yu WANG, Ping XU, Jing YANG, Yong YANG, Zhenwei YU, Bikui ZHANG, Huaijun ZHU, Xiaocong ZUO, Yi ZHANG, Liyan MIAO, and Jing ZHANG declare that they have no conflict of interest.
This article does not contain any studies with human or animal subjects performed by any of the authors.
Rights and permissions
About this article
Cite this article
Liu, X., Huang, C., Bergen, P.J. et al. 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 24, 130–142 (2023). https://doi.org/10.1631/jzus.B2200466
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1631/jzus.B2200466