Abstract:Objective To analyze the efficacy and safety of polymyxin B in the treatment of hematological malignancies with carbapenem-resistant Klebsiella pneumoniae (CRKP)-bloodstream infection (BSI). Methods Data from patients with hematologic malignancies with CRKP-BSI who received at least 3 d of polymyxin B treatment from September 2019 to June 2021 at our institution were retrospectively analyzed. All patients were initially treated with a triple regimen based on polymyxin B + tigecycline + carbapenems. Results A total of 10 patients were enrolled, and 11 CRKP strains were detected in blood culture, of which 10 CRKP strains produced Klebsiella pneumoniae carbapenemase (KPC), and 1 CRKP strain produced both KPC and metallo-beta-lactamase; 9 strains were susceptible to mucins, 7 strains were susceptible to tigecycline, 5 strains were susceptible to amikacin, and 2 strains were susceptible to compound sulfamethoxazole. All patients were accompanied by neutropenia with a mean duration of (14.1±6.4) d; all presented with fever, chills, and malaise. After treatment, six patients were cured and discharged from the hospital, and four patients died due to ineffective treatment of infectious shock; no serious adverse events related to polymyxin B occurred in all patients. Conclusion Polymyxin B can be used as a therapeutic agent for patients with hematologic malignancies with CRKP-BSI, and no polymyxin B-related serious adverse events occurred during treatment.
Li Na, Liu Nan, Zhang Ailing, Li Li, Wan Dingming, Zhang Xiaojian. Clinical observation of polymyxin B in the treatment of hematologic malignancy with CRKP-BSI[J]. China Pharmacy, 2023, 34 (04): 461-465+470.