Journal of Antimicrobial Chemotherapy (2001) 48, 881-885
© 2001 The British Society for Antimicrobial Chemotherapy
Elimination of the piperacillin/tazobactam combination during continuous venovenous haemofiltration and haemodiafiltration in patients with acute renal failure
a Department of Medicine, Divisions of Infectious Diseases and b Nephrology, c Department of Anaesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki; d Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland
The elimination of the piperacillin/tazobactam combination was studied in six patients with acute renal failure undergoing either continuous venovenous haemofiltration (CVVH) or continuous venovenous haemodiafiltration (CVVHDF) at 1 L/h and 2 L/h for 12 h. Piperacillin 4 g/tazobactam 0.5 g was given iv on three successive treatment periods and their concentrations in plasma, ultrafiltrate/dialysate and urine were determined for 12 h after each dose. The elimination half-life of piperacillin during CVVH (7.7 ± 2.3 h; mean ± s.d.) was significantly longer than during CVVHDF 1 L/h (6.7 ± 1.9 h) or 2 L/h (6.1 ± 2.0 h) (P< 0.05). Corresponding values for tazobactam were 13.9 ± 3.9, 11.6 ± 3.3 and 9.4 ± 2.4 h, respectively (P< 0.05). Total piperacillin clearance during CVVH (3.89 ± 1.23 L/h) was significantly lower than during CVVHDF 1 L/h (5.06 ± 1.68 L/h) or 2 L/h (5.48 ± 2.11 L/h) (P< 0.05). The corresponding tazobactam clearance values were 2.42 ± 0.75, 3.13 ± 0.66 and 3.75 ± 1.43 L/h, respectively. The mean 12 h elimination of piperacillin and tazobactam in ultrafiltrate/dialysate was 29% and 37% during CVVH, 42% and 57% during CVVHDF (1 L/h), and 46% and 69% during CVVHDF (2 L/h). We recommend 8 hourly dosing of patients with renal failure on CVVH or CVVHDF with dialysis flow rates of 1 or 2 L/h treated with piperacillin 4 g/tazobactam 0.5 g.
* Correspondence address. Department of Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 340, FIN-00029 HUS, Finland. Tel: +358-9-471-73573; Fax: +358-9-471-74013; E-mail: matti.valtonen{at}hus.fi
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  K.-H. Oh, C. Kim, H. Lee, H. Lee, J. Y. Jung, N. J. Kim, K.-S. Yu, K.-H. Shin, I.-J. Jang, and C. Ahn Pharmacokinetics of Intravenous Piperacillin Administration in Patients Undergoing On-Line Hemodiafiltration Antimicrob. Agents Chemother., August 1, 2009; 53(8): 3266 - 3268. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Moriyama, S. A Henning, M. M Neuhauser, R. L Danner, and T. J Walsh Continuous-Infusion {beta}-Lactam Antibiotics During Continuous Venovenous Hemofiltration for the Treatment of Resistant Gram-Negative Bacteria Ann. Pharmacother., July 1, 2009; 43(7): 1324 - 1337. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Fuhrmann, P. Schenk, W. Jaeger, M. Miksits, N. Kneidinger, J. Warszawska, U. Holzinger, R. Kitzberger, and F. Thalhammer Pharmacokinetics of voriconazole during continuous venovenous haemodiafiltration J. Antimicrob. Chemother., November 1, 2007; 60(5): 1085 - 1090. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Kubin and A. Dzierba The Effects of Continuous Renal Replacement on Anti-infective Therapy in the Critically Ill Journal of Pharmacy Practice, April 1, 2005; 18(2): 109 - 117. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Arzuaga, J. Maynar, A. R. Gascon, A. Isla, E. Corral, F. Fonseca, J. A. Sanchez-Izquierdo, J. Rello, A. Canut, and J. L. Pedraz Influence of Renal Function on the Pharmacokinetics of Piperacillin/Tazobactam in Intensive Care Unit Patients During Continuous Venovenous Hemofiltration J. Clin. Pharmacol., February 1, 2005; 45(2): 168 - 176. [Abstract] [Full Text] [PDF]
|
|