T20 Blast: Surrey close in on quarter-final spot, North Group still tight
Surrey closed in on qualification from the South Group, while Notts Outlaws and Birmingham Bears strengthened their quarter-final chances after another action-packed round of games in the T20 Blast.
In the South Group, Surrey all-rounder Sam Curran blasted six sixes as Surrey hammered Glamorgan to stay on course for a home quarter-final and Jordan Cox smashed 82 from 44 balls to keep Kent Spitfires in contention with victory at Sussex.North Group - Buttler fires but Lightning lose At Chester-le-Street the Bears opted to bowl first and Chris Woakes soon ousted Alex Lees while Danny Briggs picked up 2-26 off four overs after dismissing Michael Jones and Brydon Carse in consecutive deliveries.
Notts Outlaws bounced back from being bowled out for 99 at Northants by beating struggling Leicestershire Foxes. Willey and Ben Sanderson then shared four wickets in the opening 32 balls to reduce the hosts to 22-4 in reply. Chris Cooke provided the only real resistance in reply, collecting 21 runs from five Sean Abbott deliveries to reach 45 from 22 deliveries, only to become one of Chris Jordan's four scalps soon after for 49. Jordan claimed 4-21 from four overs while Billy Root and Will Smale were the only other contributions of note.
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Polymyxin B therapy based on therapeutic drug monitoring in carbapenem-resistant organisms sepsis: the PMB-CROS randomized clinical trial - Critical CareBackground The appropriate administration regimen of polymyxin B is yet controversial. The present study aimed to explore the optimal dose of polymyxin B under therapeutic drug monitoring (TDM) guidance. Methods In China’s Henan province, 26 hospitals participated in a randomized controlled trial. We included patients with sepsis caused by carbapenem-resistant Gram-negative bacteria (CR-GNB) susceptible to polymyxin B. The patients were randomly divided into a high-dose (HD) group or a low-dose (LD) group and received 150 mg loading dose, 75 mg every 12 h and 100 mg loading dose, 50 mg every 12 h, respectively. TDM was employed to determine if the dose of polymyxin B needs adjustment based on the area under the concentration–time curve across 24 h at a steady state (ssAUC0–24) of 50–100 mg h/L. The primary outcome was the 14-day clinical response, and the secondary outcomes included 28- and 14-day mortality. Results This trial included 311 patients, with 152 assigned to the HD group and 159 assigned to the LD group. Intention-to-treat analysis showed that the 14-day clinical response was non-significant (p = 0.527): 95/152 (62.5%) in the HD group and 95/159 (59.7%) in the LD group. Kaplan–Meier’s 180-day survival curve showed survival advantage in the HD group than in the LD group (p = 0.037). More patients achieved the target ssAUC0–24 in the HD than in the LD group (63.8% vs. 38.9%; p = 0.005) and in the septic shock subgroup compared to all subjects (HD group: 71.4% vs. 63.8%, p = 0.037; LD group: 58.3% vs. 38.9%, p = 0.0005). Also, the target AUC compliance was not correlated with clinical outcomes but with acute kidney injury (AKI) (p = 0.019). Adverse events did not differ between the HD and LD groups. Conclusion A fixed polymyxin B loading dose of 150 mg and a maintenance dose of 75 mg every 12 h was safe for patients with sepsis caused by CR-GNB and improves long-term survival. The increased AUC was associated with increased incidence of AKI, and TDM results
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