2026-04-17T13:56:29Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1983372026-02-24T06:53:49Zcom_2072_1057col_2072_478815col_2072_478916col_2072_478917

00925njm 22002777a 4500 dc Martínez Casanova, Javier author Esteve Pitarch, Erika author Colom Codina, Helena author Gumucio Sanguino, Víctor Daniel author Cobo Sacristán, Sara author Shaw, Evelyn author Maisterra Santos, Kristel author Sabater Riera, Joan author Pérez Fernández, Xosé Luis author Rigo Bonnin, Raúl author Tubau Quintano, Fe author Carratalà, Jordi author Padullés Zamora, Ariadna author 2023-05-23T11:37:04Z 2023-05-23T11:37:04Z 2023-03-07 2023-04-21T12:19:37Z Critically ill patients undergo significant pathophysiological changes that affect antibiotic pharmacokinetics. Piperacillin/tazobactam administered by continuous infusion (CI) improves pharmacokinetic/pharmacodynamic (PK/PD) target attainment. This study aimed to characterize piperacillin PK after CI administration of piperacillin/tazobactam in critically ill adult patients with preserved renal function and to determine the empirical optimal dosing regimen. A total of 218 piperacillin concentrations from 106 patients were simultaneously analyzed through the population PK approach. A two-compartment linear model best described the data. Creatinine clearance (CLCR) estimated by CKD-EPI was the covariate, the most predictive factor of piperacillin clearance (CL) interindividual variability. The mean (relative standard error) parameter estimates for the final model were: CL: 12.0 L/h (6.03%); central and peripheral compartment distribution volumes: 20.7 L (8.94%) and 62.4 L (50.80%), respectively; intercompartmental clearance: 4.8 L/h (26.4%). For the PK/PD target of 100% fT(>1xMIC), 12 g of piperacillin provide a probability of target attainment > 90% for MIC < 16 mg/L, regardless of CLCR, but higher doses are needed for MIC = 16 mg/L when CLCR > 100 mL/min. For 100% fT(>4xMIC), the highest dose (24 g/24 h) was not sufficient to ensure adequate exposure, except for MICs of 1 and 4 mg/L. Our model can be used as a support tool for initial dose guidance and during therapeutic drug monitoring. Antibiòtics betalactàmics Farmacocinètica Farmacovigilància Beta lactam antibiotics Pharmacokinetics Drug monitoring Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients