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Piperacillin Population Pharmacokinetics in Critically Ill Adults During Sustained Low-Efficiency Dialysis
- Source :
- The Annals of pharmacotherapy. 52(10)
- Publication Year :
- 2018
-
Abstract
- Sustained low-efficiency dialysis (SLED), is increasingly being used in intensive care units (ICUs) but studies informing drug dosing for such patients is lacking.To describe the population pharmacokinetics (PKs) of piperacillin/tazobactam in critically ill adults receiving SLED and to provide dosing recommendations.This prospective population PK study was conducted in adult ICU patients prescribed piperacillin/tazobactam while receiving SLED; 321 blood samples were obtained from 34 participants during and between approximately 50 SLED treatments for quantification of piperacillin and tazobactam concentrations in plasma. A population PK model was developed. Monte Carlo simulation was used to determine the probability of target attainment and pathogen-specific fractional target attainment at different doses.From a 2-compartment linear model with zero-order input, the mean (SD) clearance of piperacillin on SLED and off SLED were 4.81 (8.48) and 1.42 (1.54) L/h, respectively. Tazobactam concentrations were not sufficient for analysis. For the target of 50% fTMIC (unbound concentrations of drug are above the minimum inhibitory concentration for50% of the dosing interval), 3-g of piperacillin infused over 0.5 hours every 8 hours was appropriate for susceptible organisms with MIC ≤16 mg/L. For life-threatening infections where the target of 100% fTMIC is preferred, a 9-g dose administered as a continuous infusion every 24 hours was appropriate for susceptible organisms with MIC ≤32 mg/L.In critically ill patients receiving SLED, piperacillin doses need to be guided by the frequency of SLED treatments and susceptibility of the known or suspected pathogen.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
Tazobactam
medicine.medical_treatment
Critical Illness
030106 microbiology
Microbial Sensitivity Tests
03 medical and health sciences
0302 clinical medicine
Pharmacokinetics
Renal Dialysis
Intensive care
Medicine
Humans
Pharmacology (medical)
Renal replacement therapy
Prospective Studies
Prospective cohort study
Intensive care medicine
Dialysis
Aged
Piperacillin
business.industry
030208 emergency & critical care medicine
Middle Aged
Anti-Bacterial Agents
Renal Replacement Therapy
Intensive Care Units
Piperacillin, Tazobactam Drug Combination
Piperacillin/tazobactam
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 15426270
- Volume :
- 52
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The Annals of pharmacotherapy
- Accession number :
- edsair.doi.dedup.....63bfb372a22b710b9ea530101ab09f16