First case report of polymyxin B-induced drug fever in a patient with carbapenem-resistant Acinetobacter baumannii pneumonia.

The escalating global prevalence of carbapenem-resistant Gram-negative bacteria has significantly constrained therapeutic options, leading to the revived use of polymyxins. However, this resurgence has been paralleled by an increase in reports of associated adverse effects. No case of drug fever induced by polymyxin B (PMB) has been reported in the literature to date. We report the first case of drug fever (≥39 °C) induced by intravenous PMB in a patient with severe pneumonia caused by carbapenem-resistant Acinetobacter baumannii, accompanied by tachypnea following concomitant nebulized PMB administration. Upon intervention by the clinical pharmacist, which involved discontinuation of PMB and adjustment of the anti-infective regimen, the patient's fever resolved promptly and the infection was successfully controlled. This case highlights a severe and previously unreported adverse drug reaction to PMB, underscoring the necessity for vigilant monitoring and proactive antimicrobial stewardship in managing infections.