Pharmacokinetics and outcome of tazobactam/piperacillin in Japanese patients undergoing low-fow continuous renal replacement therapy: dosage considerations

• Published in: Clinical pharmacology: advances and applications 2017-01, Vol.9, p.39
• Main Authors: Kohama, Hanako, Ide, Takeshi, Ikawa, Kazuro, Morikawa, Norifumi, Nishi, Shinichi
• Format: Article
• Language: English
• Subjects: Dosage and administration; Methods; Patient outcomes; Pharmacokinetics; Piperacillin; Renal replacement therapy; Tazobactam
• ISSN: 1179-1438; 1179-1438
• DOI: 10.2147/CPAA.S127502

Background: Tazobactam/piperacillin (TAZ/PIPC), which is often combined with continuous renal replacement therapy (CRRT), induces renal excretion and is thought to have a high component removal rate for blood purification. CRRT procedures vary depending on the country, region, and institution. It is not clear whether the dose of TAZ/PIPC for use in Japan can be determined based on studies conducted in other countries. Therefore, in this study, we examined the suitability of recommended dose in Japan. Methods: The study subjects consisted of 10 patients who received TAZ/PIPC during CRRT in the intensive care unit of Hyogo College of Medicine, Nishinomiya, Japan. We used a one-compartment model to characterize and parameterize the pharmacokinetics of TAZ/PIPC because their blood levels were eliminated monoexponentially. Results: Compared with the data of healthy adults, the half-lives ([t.sub.1/2] ) of both PIPC and TAZ were prolonged while their clearance rates decreased. Conclusion: For the continuous hemodiafiltration procedure adopted in Japan, we concluded that the dose and frequency were appropriate because the patients who received PIPC/TAZ 2.25 g twice a day during continuous hemodiafiltration maintained appropriate blood levels of both PIPC and TAZ. Keywords: hemodiafiltration, antibiotics, dosage regimen