RT Journal Article
T1 Population Pharmacokinetics of Piperacillin in Non-Critically Ill Patients with Bacteremia Caused by Enterobacteriaceae
A1 Merino-Bohórquez, Vicente
A1 Docobo-Pérez, Fernando
A1 Valiente-Méndez, Adoración
A1 Delgado-Valverde, Mercedes
A1 Cameán, Manuel
A1 Hope, William W.
A1 Pascual, Álvaro
A1 Rodríguez-Baño, Jesús
K1 Bloodstream infection
K1 Renal function
K1 Neurotoxicity
K1 Nephrotoxicity
K1 Pharmacokinetics
K1 Piperacillin–tazobactam
K1 Enterobacteriaceae
K1 Sepsis
K1 Pruebas de función renal
K1 Síndromes de neurotoxicidad
K1 Farmacocinética
K1 Combinación de piperacilina y tazobactam
AB This study analyzes the pharmacokinetic variability of piperacillin in non-critically ill patients with Enterobacteriaceae bloodstream infections (EBSI) and explores predicted clinical outcomes and piperacillin-related neurotoxicity under different renal conditions. Hospitalized, non-critically ill patients treated with piperacillin-tazobactam for EBSI were included. Four serum samples per patient were collected and analyzed. A population pharmacokinetic model was developed using the Pmetrics package for R. Monte Carlo simulations of various dosage regimens of 4 g piperacillin, administered q8 h or q12 h by short (0.5 h) or long (4 h) infusion, following the different glomerular filtration rate (GFR) categories used to classify chronic kidney disease (Kidney Disease: Improving Global Outcomes, KDIGO) to determine the probability of target attainment (PTA) using a free drug concentrations above the minimal inhibitory concentration (fT > MIC) of 50% for efficacy and targets for piperacillin-associated neurotoxicity. Twenty-seven patients (102 samples) were included. Extended piperacillin infusions reached a PTA > 90% (50%fT > MIC) within the susceptibility range, although a loading dose did not greatly improve the expected outcome. Long infusions reduced the expected toxicity in patients with severe renal impairment. The study supports the use of extended infusions of piperacillin in non-critically ill patients with EBSI. No benefits of a loading dose were expected in our population. Finally, extended infusions may reduce the risk of toxicity in patients with severe renal impairment.
PB MDPI
YR 2021
FD 2021-03-25
LK http://hdl.handle.net/10668/3977
UL http://hdl.handle.net/10668/3977
LA en
NO Merino-Bohórquez V, Docobo-Pérez F, Valiente-Méndez A, Delgado-Valverde M, Cameán M, Hope WW, et al. Population Pharmacokinetics of Piperacillin in Non-Critically Ill Patients with Bacteremia Caused by Enterobacteriaceae. Antibiotics. 2021 Mar 25;10(4):348
DS RISalud
RD Apr 8, 2025