We read with interest the report by Thamlikitkul et al. describing polymyxin B exposures in 19 adult patients with and without renal insufficiency (1). No significant difference was observed in the dose-normalized 24-h area under the concentration-time curve (AUC24) at steady state between those with normal renal function, defined as an estimated creatinine clearance (CLCR) of 80 ml/min (n = 5; mean CLCR, 90.0 ± 12.5 ml/min; mean AUC24, 28.6 ± 7.0 mg · h/liter) and those with renal insufficiency (n 14; mean CLCR, 40.8 21.8 ml/min; mean AUC24, 29.7 ± 11.2mg · h/liter; P = 0.80). A sensitivity analysis using lower CLCR threshold values of <60and <40 ml/min yielded similar results.
- Polymyxin B