2026-04-17T16:16:17Zhttps://recercat.cat/oai/request

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

Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients Martínez Casanova, Javier Esteve Pitarch, Erika Colom Codina, Helena Gumucio Sanguino, Víctor Daniel Cobo Sacristán, Sara Shaw, Evelyn Maisterra Santos, Kristel Sabater Riera, Joan Pérez Fernández, Xosé Luis Rigo Bonnin, Raúl Tubau Quintano, Fe Carratalà, Jordi Padullés Zamora, Ariadna Antibiòtics betalactàmics Farmacocinètica Farmacovigilància Beta lactam antibiotics Pharmacokinetics Drug monitoring 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. 2023-05-23T11:37:04Z 2023-05-23T11:37:04Z 2023-03-07 2023-04-21T12:19:37Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.3390/antibiotics12030531 Antibiotics, 2023, vol. 12, num. 3, p. 531 https://doi.org/10.3390/antibiotics12030531 cc by (c) Martínez Casanova, Javier et al., 2023 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess MDPI AG Articles publicats en revistes (Farmàcia, Tecnologia Farmacèutica i Fisicoquímica)