Preliminary program

This opinion-leader conference will feature cutting-edge presentations by world leaders in research and clinical use of polymyxins, and regulatory and funding agency representatives. Each symposium session will provide opportunity for discussion and input from the audience. In addition, within each symposium key issues will be identified to go on the agenda for the final symposium of the conference, Time travel: 60 years of polymyxins and the road ahead (see below), in which recommendations will be made to guide the clinical use of polymyxins and identify high-priority areas for further research. Below is the Preliminary Program for the 2nd International Conference on Polymyxins.

Tuesday 22 September 2015

8:00 - 9:00 Registration
9:00 - 10:15

Jian Li
SESSION 1: Welcome and Setting the scene
Jian Li and Keith Kaye (10 min)

Polymyxins and the Prato consensus
Roger Nation (30 min)

Gram-negative problem: Polymyxins in an age of new antibiotics
David Paterson (30 min)

Discussion (5 min)
10:15 - 10:45 Morning tea, poster viewing and networking

10:45 - 12:45

David Paterson
Roger Nation

SESSION 2: Clinical use of colistin and polymyxin B: What have we learned?

Parenteral use of colistin in critically-ill patients
Perspective from America: Keith Kaye (20 min)
Perspective from Europe: Ilias Karaiskos (20 min)
Perspective from Asia: Visanu Thamlikitkul (20 min)

Increasing use of polymyxin B: Are we moving in the right direction?
Alexandre Zavascki (20 min)

Lung infections: Is inhalation of polymyxins required?
Richard Wunderink (15 min)

Polymyxins in pediatrics: What is new?
Emmanuel Roilides (15 min)

Discussion (10 min)

12:45 - 14:15 Lunch, poster viewing and networking
14:15 - 16:00

Keith Kaye
Vincent Tam
SESSION 3: Optimized dosing of colistin and polymyxin B in patients: Are they from the same mold?

Selecting the colistin dose: Walking the tightrope between antibacterial activity and nephrotoxicity
Roger Nation (30 min)

Parenteral polymyxin B in patients: Does its PK show advantages over colistin?
Alan Forrest (20 min)

Advances in the PK of intraventricular and intrathecal colistin for CNS infections
Ilias Karaiskos (15 min)

Optimizing lung exposure by pulmonary delivery for pneumonia
Mike Dudley (15 min)

What is the role of TDM and what are the challenges?
William Couet (15 min)

Discussion (10 min)
16:00 - 16:30 Afternoon tea, poster viewing and networking
16:30 - 17:10

David Paterson
William Couet
SESSION 4: MIC measurement and breakpoints: Update since 2013

MIC measurements: DOs and DON'Ts
Alasdair MacGowan (15 min)

Polymyxin breakpoints: Are we there yet?
Johan Mouton (15 min)

Discussion (10 min)
17:10 - 18:00

Ursula Theuretzbacher
Alexandre Zavascki

SESSION 5: Oral presentations of selected abstracts
Abstract O-1: S. Luque, L. Sorlí, S. Grau, N. Campillo, N. de Benito, C. Segura, M. Montero, E. Esteve, B. Mirelis, V. Pomar, J. Cuquet, C. Martí, P. Garro, J. P. Horcajada. Validation of a plasma concentration cut-off value of colistin as a predictor for nephrotoxicity in patients with multidrug-resistant Gram-negative bacterial infections.

Abstract O-2: J. M. Pogue, N. S. Mudegowdra, G. Balakrishnan, M. Salim, B. Nisham, A. Pervaiz, B. Navalkele, H. Shaikh, K. S. Kaye. Lack of association between colistin loading dose and acute kidney injury.

Abstract O-3: C. S. Abboud, A. C. Pignatari, C. Kiffer, V. L. Barbosa, E. Zandonadi, E. Sousa, J. Monteiro, A. Forrest, G. G. Rao. Efficacy and toxicodynamics for extended use of polymyxin B for treatment of carbapenem-resistant Enterobacteriaceae mediastinitis.

Abstract O-4: C. B. Landersdorfer, T. H. Nguyen, L. T. Lieu, R. J. Bischof, R. L. Nation, M. P. McIntosh. Substantial targeting advantage of pulmonary compared to intravenous colistin sulfate and colistin methanesulfonate in sheep.

12 min each, incl 10 min presentation + 2 min questions

18:30 - 20:00 Welcome function (Hilton La Jolla Torrey Pines)
Wednesday 23 September 2015
9:00 - 10:15

Jason Pogue
Paul Tulkens
SESSION 6: Nephrotoxicity of polymyxins: The Achilles Heel

Epidemiological risk factors for nephrotoxicity
Jason Pogue (15 min)

Nephrotoxicity of colistin in critically-ill patients: What is the relationship with plasma concentration?
Alan Forrest (15 min)

Is polymyxin B more nephrotoxic than colistin?
Vincent Tam (15 min)

Polymyxin-induced nephrotoxicity: Knowns and unknowns
Jian Li (15 min)

Discussion (15 min)
10:15 - 10:45 Morning tea, poster viewing and networking
10:45 - 12:15

Robert Bonomo
Johan Mouton
SESSION 7: Polymyxin combinations: Why and how?

Combination therapy for Acinetobacter, CRE and Pseudomonas: Different organisms, same stories?
Mical Paul (20 min)

Controlled clinical studies of colistin-meropenem combination: Where are we at?
NIH study: Keith Kaye (20 min)
AIDA study: Johan Mouton (20 min)

Polymyxin combination therapy: Do we need to think outside the box?
Brian Tsuji (20 min)

Discussion (10 min)
12:15 - 13:45 Lunch, poster viewing and networking
13:45 - 15:15

Paul Tulkens
Mike Dudley
SESSION 8: Discovery of new improved polymyxins: What is in the pipeline?

Chemistry and structure-activity relationship of polymyxins
Tony Velkov (20 min)

How do the Gram-negatives escape polymyxin killing?
Robert Bonomo (20 min)

Monash-Rempex program
Kade Roberts (10 min)

AstraZeneca program
Gunther Kern (10 min)

Queensland program
Matt Cooper (10 min)

Novactabio program
Mike Dawson (10 min)

Discussion (10 min)
15:15 - 15:45 Afternoon tea, poster viewing and networking
15:45 - 16:45

Brian Tsuji
Jason Pogue

SESSION 9: Oral presentations of selected abstracts by postdoc and students and Young Investigator Awards
Young investigator: <2 years of PhD or currently studying for HDR

Abstract O-5: Y. D. Benattar, M. Omar, S. Altunin, D. Yahav, Y. Zak-Doron, L. Leibovici, M. Paul. Clinical effectiveness and safety of high-dose colistin.

Abstract O-6: M. Zhao, X. Wu, Y. Fan, J. Zhang, Y. Zhang, J. Yu, L. Peng, Y. Yu, H. Huang, M. Wang, Y. Chen. Population pharmacokinetics of colistimethate and formed colistin in patients with hospital-acquired pneumonia.

Abstract O-7: M. H. Rigatto, D. Falci, N. T. Lopes, A. P. Zavascki. Impact of polymyxin B dose on the mortality of patients on renal replacement therapy.

Abstract O-8: E. A. Lakota, G. G. Rao, C. B. Landersdorfer, R. L. Nation, J. Li, K. S. Kaye, A. Forrest. Improving clinical utility of polymyxin B through a meta-analysis of toxicodynamics and development of an adaptive feedback control algorithm.
Abstract O-9: J. R. Lenhard, S-E. Cheah, C. B. Landersdorfer, J. B. Bulitta, P. N. Holden, A. Morocco, V. Thamlikitkul, G. G. Rao, M. J. Satlin, V. Petraitis, T. J. Walsh, A. Forrest, R. L. Nation, J. Li, B. T. Tsuji. Novel polymyxin B regimens in combination with meropenem suppress Acinetobacter baumannii resistance over 14 days.

12 min each, including 10 min presentation + 2 min questions

Vote by the Organizing Committee members and the outcome will be announced in the last session

16:45 - 17:30

Dennis Dixon
Paul Tulkens
SESSION 10: Combating antibacterial resistance: NIH and EU initiatives

NIH Antibacterial Resistance Leadership Group
Dennis Dixon (15 min)

The European road map against antimicrobial resistance
Paul Tulkens (15 min)

Discussion (15 min)
18:30 - late Conference dinner (Hilton La Jolla Torrey Pines)
Thursday 24 September 2015
8:00 - 9:15

Mike Dudley
Ursula Theuretzbacher
SESSION 11: Regulatory and industry issues and actions

Policy actions since the Prato conference
Ursula Theuretzbacher (10 min)

Structural evidence for a new understanding of the nature of CMS
Robert Kenyon (15 min)

USP monograph for polymyxin B sulfate
Ahalya Wise (15 min)

FDA strategies
Kimberly Bergman (15 min)

Discussion (5 min)
9:15 - 9:45 Morning tea and networking

9:45 - 11:45

Keith Kaye
Jian Li

SESSION 12: Time travel: 60 years of polymyxins and the road ahead

Young Investigator Awards (9:45 - 9:55)
Jian Li, Keith Kaye and the awardees

Clinical experience from a senior ID doctor: Using polymyxins in the 1960s (9:55 - 10:15)
Donald Kaye

The panel Polymyxins: Advances and challenges (10:15 - 11:40)

Key topics identified in this conference will be discussed by a panel, with input from the audience.

Recommendations will be made on aspects impacting the future clinical use of polymyxins and high-priority areas for research.

Panel members: each group will have ~5-min presentation (with max 3 slides) (25 min in total) followed by discussion (60 min in total).

Panel Group 1 (Clinical use, nephrotoxicity, discussion on potential guideline etc)
David Paterson
Alexandre Zavascki

Panel Group 2 (PK/PD/TD and TDM)
Roger Nation
William Couet
Alan Forrest

Group 3 (Combinations, susceptibility test and breakpoints)
Johan Mouton

Panel Group 4 (Mechanisms and pre-clinical combinations)
Brian Tsuji
Tony Velkov

Panel Group 5 (Inhalation, drug discovery, regulatory and industry aspects)
Mike Dudley
Vincent Tam

The 3rd International Conference on Polymyxins: When and where? (11:40 - 11:45)
Keith Kaye

Conference close

11:45 - 13:15 Lunch and departure