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- Klastrup, Vibeke (författare)
Population Pharmacokinetics of Piperacillin following Continuous Infusion in Critically Ill Patients and Impact of Renal Function on Target Attainment
- Artikel/kapitelEngelska2020
Förlag, utgivningsår, omfång ...
- 2020
- printrdacarrier
Nummerbeteckningar
- LIBRIS-ID:oai:DiVA.org:uu-408727
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-408727URI
- https://doi.org/10.1128/AAC.02556-19DOI
Kompletterande språkuppgifter
- Språk:engelska
- Sammanfattning på:engelska
Ingår i deldatabas
- SwePubSwePub
Klassifikation
Anmärkningar
- Title in thesis list of papers: Population pharmacokinetics of piperacillin following continuous infusion in critically ill patients: Impact of renal function on target attainment
- Pharmacokinetic changes are often seen in patients with severe infections. Administration by continuous infusion has been suggested to optimize antibiotic exposure and pharmacokinetic/pharmacodynamic (PK/PD) target attainment for β-lactams. In an observational study, unbound piperacillin concentrations (n = 196) were assessed in 78 critically ill patients following continuous infusion of piperacillin-tazobactam (ratio 8:1). The initial dose of 8, 12, or 16 g (piperacillin component) was determined by individual creatinine clearance (CRCL). Piperacillin concentrations were compared to the EUCAST clinical breakpoint MIC for Pseudomonas aeruginosa (16 mg/liter), and the following PK/PD targets were evaluated: 100% free time (fT) > 1× MIC and 100% fT > 4× MIC. A population pharmacokinetic model was developed using NONMEM 7.4.3 consisting of a one-compartment disposition model with linear elimination separated into nonrenal and renal (linearly increasing with patient CRCL) clearances. Target attainment was predicted and visualized for all individuals based on the utilized CRCL dosing algorithm. The target of 100% fT > 1× MIC was achieved for all patients based on the administered dose, but few patients achieved the target of 100% fT > 4× MIC. Probability of target attainment for a simulated cohort of patients showed that increasing the daily dose by 4-g increments (piperacillin component) did not result in substantially improved target attainment for the 100% fT > 4× MIC target. To conclude, in patients with high CRCL combined with high-MIC bacterial infections, even a continuous infusion (CI) regimen with a daily dose of 24 g may be insufficient to achieve therapeutic concentrations.
Ämnesord och genrebeteckningar
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Infektionsmedicin hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Infectious Medicine hsv//eng
- beta-lactam antibiotic
- continuous infusion
- critically ill
- pharmacokinetics
- piperacillin
- Farmaceutisk farmakologi
- Pharmaceutical Pharmacology
- Klinisk farmakologi
- Clinical Pharmacology
Biuppslag (personer, institutioner, konferenser, titlar ...)
- Thorsted, AndersUppsala universitet,Institutionen för farmaceutisk biovetenskap(Swepub:uu)andth549 (författare)
- Storgaard, Merete (författare)
- Christensen, Steffen (författare)
- Friberg, LenaUppsala universitet,Institutionen för farmaceutisk biovetenskap(Swepub:uu)lenasimo (författare)
- Öbrink-Hansen, Kristina (författare)
- Uppsala universitetInstitutionen för farmaceutisk biovetenskap (creator_code:org_t)
Sammanhörande titlar
- Ingår i:Antimicrobial Agents and Chemotherapy64:70066-48041098-6596
Internetlänk
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- Antimicrobial Agents and Chemotherapy (Sök värdpublikationen i LIBRIS)
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- Klastrup, Vibeke
- Thorsted, Anders
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- Öbrink-Hansen, K ...
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