Related Experiment Video

Updated: Jan 21, 2026

Measuring RAN Peptide Toxicity in C. elegans
10:49

Measuring RAN Peptide Toxicity in C. elegans

Published on: April 30, 2020

7.1K

Toxicity in Patients

Jason M Pogue1, Vincent H Tam2

  • 1Department of Pharmacy Services, Sinai-Grace Hospital, Detroit Medical Center, Detroit, MI, USA. jpogue@dmc.org.

Advances in Experimental Medicine and Biology
|August 1, 2019
PubMed

Insights

Polymyxin antibiotics can cause significant kidney damage (nephrotoxicity) in 30-60% of patients. This review details risk factors, including dose and serum levels, for this common adverse event.

Area of Science:

  • Pharmacology
  • Nephrology
  • Infectious Diseases

Background:

  • Polymyxins are crucial last-resort antibiotics for multidrug-resistant Gram-negative infections.
  • Nephrotoxicity is a major dose-limiting toxicity, restricting their clinical use.
  • Understanding nephrotoxicity is vital for optimizing patient care and antibiotic stewardship.

Purpose of the Study:

  • To comprehensively review polymyxin-induced nephrotoxicity.
  • To identify and analyze risk factors associated with this adverse event.
  • To discuss the impact of dosing, serum concentrations, and drug selection on kidney injury.

Main Methods:

  • Literature review and analysis of existing studies on polymyxin nephrotoxicity.
  • Assessment of clinical data regarding incidence and risk factors.
  • Examination of pharmacokinetic and pharmacodynamic principles related to toxicity.

Main Results:

  • Nephrotoxicity affects 30-60% of patients receiving systemic polymyxins.
  • Key risk factors include higher doses, elevated serum concentrations, and specific polymyxin agents.
  • Less common but significant adverse events associated with polymyxins are also identified.

Conclusions:

  • Polymyxin nephrotoxicity is a prevalent and serious concern.
  • Careful patient selection, dose optimization, and therapeutic drug monitoring are essential.
  • Further research into mitigating polymyxin toxicity is warranted to preserve their clinical utility.
Keywords:
ColistimethateColistinGram-negative bacteriaNephrotoxicityNon-renal toxicitiesPolymyxin B

More Related Videos

Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model06:08

Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model

Published on: February 10, 2023

1.7K
Gap Junctional Intercellular Communication: A Functional Biomarker to Assess Adverse Effects of Toxicants and Toxins, and Health Benefits of Natural Products05:27

Gap Junctional Intercellular Communication: A Functional Biomarker to Assess Adverse Effects of Toxicants and Toxins, and Health Benefits of Natural Products

Published on: December 25, 2016

15.5K

Related Concept Videos

Toxic Reactions: Overview01:26

Toxic Reactions: Overview

When toxic substances penetrate the human body, they disseminate to various tissues, undergoing metabolic changes. This process yields reactive metabolites that may covalently bind with specific target molecules, resulting in toxicity.
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
1.8K
Patient-centered Care01:13

Patient-centered Care

Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
2.9K
Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
235
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
229
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
263
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
196