Monte Carlo simulation to optimize polymyxin B dosing regimens for the treatment of Gram-negative bacteremia

Polymyxin B demonstrates high efficacy for Gram-negative bacteremia with MIC ≤1 mg/L. However, efficacy diminishes as MIC increases, particularly for <i>P. aeruginosa</i> and <i>K. pneumoniae</i>, where 500,000 IU q12h and 1.25 mg/kg q12h regimens may result in suboptimal outcomes. For CRRT patients with <i>K. pneumoniae</i> bacteremia, therapeutic drug monitoring and dose adjustments are crucial to mitigate treatment failure risks.