Pharmacokinetics of Intravenous Piperacillin Administration in Patients Undergoing On-Line Hemodiafiltration

Oh, Kook‐Hwan; Kim, Chiweon; Lee, Hankyu; Lee, Hajeong; Jung, Ji Yong; Kim, Nam Joong; Yu, Kyung‐Sang; Shin, Kyung‐Jae; Jang, In‐Jin; Ahn, Curie

doi:10.1128/aac.01670-08

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…Therefore, the addition of convection to diffusion might increase its clearance. Indeed, piperacillin clearance was larger during online HDF as compared with historical data from patients who were treated with conventional HD [23]. …”

Section: Pharmacokinetics and Pharmacodynamics Of Anti-infective Agenmentioning

confidence: 99%

Optimization of anti-infective dosing regimens during online haemodiafiltration

Jager

Zandvliet

Touw

et al. 2017

Clinical Kidney Journal

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Online haemodiafiltration (HDF) is increasingly used in clinical practice as a routine intermittent dialysis modality. It is well known that renal impairment and renal replacement therapy can substantially affect the pharmacokinetic behaviour of several drugs. However, surprisingly few data are available on the need for specific dose adjustments during HDF. Due to convection, drug clearance may be increased during HDF as compared with standard haemodialysis. This may be of particular interest in patients undergoing anti-infective therapy, since under-dosing may compromise patient outcomes and promote the emergence of bacterial resistance. Drug clearance during HDF is determined by (i) dialysis characteristics, (ii) drug characteristics and (iii) patient characteristics. In this review, we will discuss these different determinants of drug clearance during HDF and advise on how to adjust the dose of antibacterial, antimycotic and antiviral agents in patients undergoing HDF. In addition, the possible added value of therapeutic drug monitoring is discussed. The review provides guidance for optimization of anti-infective dosing regimens in HDF patients.

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Section: Pharmacokinetics and Pharmacodynamics Of Anti-infective Agenmentioning

confidence: 99%

Optimization of anti-infective dosing regimens during online haemodiafiltration

Jager

Zandvliet

Touw

et al. 2017

Clinical Kidney Journal

View full text Add to dashboard Cite

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“…Race is one of the important individual characteristics and ethnic differences may affect drug pharmacokinetics or pharmacodynamics [ 11 12 ]. Several previous studies evaluated the population pharmacokinetics and pharmacodynamics of piperacillin and tazobactam in Korean patients who had burn injuries and renal failure [ 13 14 ]. However, to our knowledge, no studies have evaluated the population pharmacokinetics in hospitalized Korean patients with infections.…”

Section: Introductionmentioning

confidence: 99%

Population Pharmacokinetic Analysis of Piperacillin/Tazobactam in Korean Patients with Acute Infections

et al. 2016

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BackgroundFor more effective and safer usage of antibiotics, the dosing strategy should be individualized based on the patients’ characteristics, including race. The aim of this study was to investigate the population pharmacokinetic (PK) profiles of piperacillin and tazobactam in Korean patients with acute infections.Materials and MethodsAt least four consecutive 2/0.25 g or 4/0.5 g doses of piperacillin/tazobactam (TZP) were intravenously infused over 1 h every 8 h for patients with creatinine clearance (CLcr) ≤50 ml/min or CLcr >50 mL/min, respectively. Blood samples from 33 patients at a steady-state were taken pre-dose and at 0 min, 30 min, and 4-6 h after the fourth infusion. The population PK analysis was conducted using a non-linear mixed-effects method. A likelihood ratio test was used to select significant covariates, with significance levels of P <0.05 for selection and P <0.01 for elimination.ResultsBoth piperacillin PK and tazobactam PK were well described by a two-compartment model with first-order elimination. Creatinine clearance and body weight, as covariates on clearance (CL) and volume of central compartment (V1), were selected among the covariates possibly affecting PK parameters of both drugs. CL was defined as CL = 2.9 + 4.03 × CLcr /47 for piperacillin and CL = 1.76 + 4.81 × CLcr /47 for tazobactam. V1 was defined as V1 = 19.5 × weight/60 for piperacillin and V1 = 22.6 × weight/60 for tazobactam.ConclusionThe PK profiles of TZP at a steady-state in Korean patients with acute infections were well described by a two-compartment model with first-order elimination. Both piperacillin and tazobactam clearances were significantly influenced by creatinine clearance.

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