{
  "abstract": "Background\n\nThe area under the 24-hour concentration-time curve (AUC0-24h) is a key pharmacokinetic parameter for polymyxin B (PMB), but the optimal exposure target in critically ill patients remains uncertain.Objective\n\nThis study aimed to investigate the relationship between PMB AUC0-24h and clinical efficacy in patients with carbapenem-resistant hospital-acquired pneumonia (HAP), and to identify the optimal therapeutic AUC0-24h range for PMB.Methods\n\nThis retrospective observational study included patients with carbapenem-resistant HAP who received intravenous PMB and therapeutic drug monitoring. Plasma PMB concentrations were measured by validated ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The primary outcome was 14-day clinical treatment success, and the secondary outcome included acute kidney injury (AKI). Logistic regression and restricted cubic spline analyses were used to assess exposure-outcome relationships.Results\n\nA total of 138 patients were included, the median age was 68 years, and 110 (79.7%) were male. Clinical success was achieved in 63 (45.7%) patients. Carbapenem-resistant Acinetobacter baumannii accounted for 77.5% of infections. The median AUC0-24h of PMB was 77.5 (55.6, 105.6) mg·h/L. An AUC0-24h > 77 mg·h/L enabled to predict the clinical treatment success, while AUC0-24h > 110 mg·h/L enabled to predict the AKI incidence. In multivariable analysis, AUC0-24h < 77 mg·h/L was an independent risk factor for reduced clinical treatment success (OR: 0.33, 95% CI: 0.13-0.78; p = 0.013), while AUC0-24h > 110 mg·h/L significantly increased AKI risk (OR: 3.24, 95% CI: 1.06-10.47; p = 0.043).Conclusion\n\nThe AUC0-24h of PMB is closely associated with both 14-day clinical treatment success rates and the incidence of AKI in patients with carbapenem-resistant HAP, with an optimal range from 77 to 110 mg·h/L.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, People's Republic of China.",
    "Department of Pharmacy, Zhongda Hospital, Southeast University, School of Medicine, Southeast University, Nanjing, 210009, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mengru Xiong"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaoting Xu"
    },
    {
      "affs": [
        1
      ],
      "name": "Linlin Hu"
    },
    {
      "affs": [
        1
      ],
      "name": "Jie He"
    },
    {
      "affs": [
        0
      ],
      "name": "Hui Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenhan Hu"
    },
    {
      "affs": [
        0
      ],
      "name": "Qingyun Peng"
    },
    {
      "affs": [
        0
      ],
      "name": "Mingze Bi"
    },
    {
      "affs": [
        0
      ],
      "name": "Shijia Zhong"
    },
    {
      "affs": [
        0
      ],
      "name": "Haofei Wang",
      "orcid": "0000-0003-2845-7558"
    },
    {
      "affs": [
        0
      ],
      "name": "Shuhe Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jianfeng Xie"
    },
    {
      "affs": [
        0
      ],
      "name": "Yingzi Huang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2r653e6cyw1q1.bib",
  "cited_by": 0,
  "doi": "10.2147/dddt.s646556",
  "fulltext_url": "https://europepmc.org/articles/PMC13724033",
  "id": "2r653e6cyw1q1",
  "issns": [
    "1177-8881"
  ],
  "landing_url": "https://europepmc.org/article/MED/42968961",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2736|Antibiotics Pharmacokinetics and Efficacy"
    ]
  ],
  "openalex": "W4414129096",
  "pdf_url": "https://europepmc.org/articles/PMC13724033?pdf=render",
  "pmcid": "PMC13724033",
  "pmid": "42968961",
  "published": "2026-10-28",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/2r653e6cyw1q1.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:53Z",
      "native_id": "MED:42968961",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42968961"
    },
    {
      "first_seen": "2026-11-04T12:22:34Z",
      "native_id": "PMC13724033",
      "source": "pmc",
      "url": "https://doi.org/10.2147/dddt.s646556"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2736|Antibiotics Pharmacokinetics and Efficacy",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Optimizing Polymyxin B Exposure in Carbapenem-Resistant Organism-Associated Hospital-Acquired Pneumonia: A Retrospective Observational Study.",
  "title_text": "Optimizing Polymyxin B Exposure in Carbapenem-Resistant Organism-Associated Hospital-Acquired Pneumonia: A Retrospective Observational Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:44Z",
  "url": "https://research.draconitic.com/paper/2r653e6cyw1q1",
  "venue": "Drug design, development and therapy",
  "versions": []
}