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Xuedong Jia,1,2 Zhao Yin,1,2 Wan Zhang,1,2 Shuzhang Du1,2 1Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 2The Precision Clinical Pharmacy Key Laboratory of Henan Province, Zhengzhou, People’s Republic of ChinaCorrespondence: Xuedong Jia; Shuzhang Du, Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, ErQi District, Zhengzhou, Henan, 450052, People’s Republic of China, Email jiaxd.zzu@163.com; dushuzhang911@163.comBackground: Polymyxin B (PMB) is a remedial treatment for carbapenem-resistant Klebsiella pneumoniae (CRKP) infection; however, there is a paucity of reports on the treatment of high-level CRKP infections with polymyxin B. Studies are needed to explore its treatment efficacy and associated influencing factors.Methods: Patients with high-level CRKP infections treated with PMB during hospitalization from June 2019 to June 2021 in a hospital were retrospectively studied, and risk factors affecting the efficacy were explored by subgroup analysis.Results: A total of 92 patients were enrolled, and the results showed that the PMB-based regimen had a bacterial clearance rate of 45.7%, an all-cause discharge mortality rate of 22.8%, and an incidence of acute kidney injury (AKI) of 27.2% for high-level CRKP treatment. The combination of β-lactams other than carbapenems facilitated bacterial clearance, and the combination of electrolyte disturbances and higher APACHE II scores was detrimental to microbial clearance. Risk factors for all-cause discharge mortality were advanced age, concomitant antifungal drugs, concomitant tigecycline and incidence of AKI.Conclusion: PMB-based regimens are an effective option for the treatment of high-level CRKP infections. However, the optimal dose of treatment and the choice of combination regimens need to be explored in further studies.Keywords: efficacy, influencing factors, polymyxin B, carbapenem-res

Xi Yang,1 Linlin Wen,1 Jinqian Zheng,1 Huijuan Nie,1 Shengli Liu,1 Chengqun Chen,1 Fangying Si,1 Xiaojian Zhang,1,2 Jian Kang,1,2 Shuzhang Du,1 Zhao Yin1 1Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 2Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou, People’s Republic of ChinaCorrespondence: Zhao Yin; Shuzhang Du, Email yinzhao0601@163.com; dushuzhang911@163.comObjective: The study explores the psychological state and related influences of hospital pharmacists enclosed in extreme work environments in the post-epidemic era, and also explores potential measures to alleviate negative emotions.Methods: An embedded mixed research methodology was used. In the qualitative research phase, semi-structured interviews were carried out with 30 pharmacists consistently confined to their work environments. The data were managed and analyzed using NVivo12 software. In the quantitative research phase, 146 pharmacists with experience in extreme work environments were selected, and the data were collected through questionnaires (GAD-7 and CD-RISC-25) and self-administered questions generated during the qualitative phase. The Shapiro–Wilk test was utilized to assess data normality. Spearman correlation was conducted to evaluate correlations among self-designed questions, resilience, and anxiety.Results: The results from interviews with 30 pharmacists revealed four factors influencing the psychological state of pharmacists in the post-epidemic era: personal factors, interpersonal relationships, environmental factors, and policy and public opinion. Mitigation measures for negative emotions encompass material security, life adjustment, epidemic prevention policy, public opinion information, and organizational management. The results of a quantitative study of 146 pharmacists showed that only 1% had severe anxiety, but the psychological resilience scores were generally low, and 62% had poor psycho

Xuedong Jia,1,2 Cuohui Guo,1 Zhao Yin,1,2 Wan Zhang,1,2 Shuzhang Du,1,2 Xiaojian Zhang1,2 1Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 2The Precision Clinical Pharmacy Key Laboratory of Henan Province, Zhengzhou, People’s Republic of ChinaCorrespondence: Xuedong Jia; Shuzhang Du, Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China, Email jiaxd.zzu@163.com; dushuzhang911@163.comPurpose: To analyze the risk factors for acute kidney injury (AKI) induced by intravenous polymyxin B in Chinese patients with severe infection and to provide a reference for clinicians and pharmacists.Methods: We retrospectively analyzed patients treated with intravenous polymyxin B from August 2018 to August 2020 in a Chinese teaching hospital. Renal function was evaluated during therapy with polymyxin B and at the end of the treatment. Univariate and multivariate analyses were conducted to determine risk factors for the nephrotoxicity of polymyxin B.Results: A total of 321 patients were included, and the incidence of AKI was 26.2% and 25.1% during polymyxin B therapy and at the end of treatment, respectively. Independent risk factors for AKI during therapy with polymyxin B were septic shock, coadministration of vancomycin or loop diuretics, and advanced age (≥ 60 years), while the incidence of AKI during treatment with polymyxin B was considered to be an independent risk factor for AKI at the end of the treatment.Conclusion: Septic shock, coadministration of vancomycin or loop diuretics, and advanced age (age ≥ 60 years) were found to be risk factors for AKI induced by intravenous polymyxin B. Clinicians and pharmacists should consider these factors when designing and recommending treatment with polymyxin B.Keywords: polymyxin B, acute kidney injury, risk factors, anti-infective therapy