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Crrt, piperacillin-tazobactam

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https://www.readbyqxmd.com/read/27197907/pharmacokinetics-and-pharmacodynamics-of-extended-infusion-versus-short-infusion-piperacillin-tazobactam-in-critically-ill-patients-undergoing-crrt
#1
Matthew S Shotwell, Ross Nesbitt, Phillip N Madonia, Edward R Gould, Michael J Connor, Charbel Salem, Olufemi A Aduroja, Milen Amde, Joseph J Groszek, Peilin Wei, Maria E Taylor, Ashita J Tolwani, William H Fissell
BACKGROUND AND OBJECTIVES: Infection is the most common cause of death in severe AKI, but many patients receiving continuous RRT do not reach target antibiotic concentrations in plasma. Extended infusion of β-lactams is associated with improved target attainment in critically ill patients; thus, we hypothesized that extended infusion piperacillin-tazobactam would improve piperacillin target attainment compared with short infusion in patients receiving continuous RRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted an institutional review board-approved observational cohort study of piperacillin-tazobactam pharmacokinetics and pharmacodynamics in critically ill patients receiving continuous venovenous hemodialysis and hemodiafiltration at three tertiary care hospitals between 2007 and 2015...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26095008/pharmacokinetics-of-an-extended-4-hour-infusion-of-piperacillin-tazobactam-in-critically-ill-patients-undergoing-continuous-renal-replacement-therapy
#2
Don-Kelena Awissi, Annie Beauchamp, Elisabeth Hébert, Viviane Lavigne, Danya Lucia Munoz, Geneviève Lebrun, Michel Savoie, Mylène Fagnan, Julie Amyot, Nicolas Tétreault, Robert Robitaille, France Varin, Christian Lavallée, Vincent Pichette, Martine Leblanc
STUDY OBJECTIVE: To evaluate the pharmacokinetic and pharmacodynamic profiles of piperacillin-tazobactam administered as a 4-hour infusion in critically ill patients undergoing continuous renal replacement therapy (CRRT). DESIGN: Prospective, observational, pharmacokinetic study. SETTING: Intensive care unit of a tertiary care hospital in Montréal, Canada. PATIENTS: Twenty critically ill adults who were undergoing continuous venovenous hemodiafiltration and receiving a 4-hour infusion of piperacillin 4 g-tazobactam 0...
June 2015: Pharmacotherapy
https://www.readbyqxmd.com/read/25881576/a-multicenter-study-on-the-effect-of-continuous-hemodiafiltration-intensity-on-antibiotic-pharmacokinetics
#3
RANDOMIZED CONTROLLED TRIAL
Darren M Roberts, Xin Liu, Jason A Roberts, Priya Nair, Louise Cole, Michael S Roberts, Jeffrey Lipman, Rinaldo Bellomo
INTRODUCTION: Continuous renal replacement therapy (CRRT) may alter antibiotic pharmacokinetics and increase the risk of incorrect dosing. In a nested cohort within a large randomized controlled trial, we assessed the effect of higher (40 mL/kg per hour) and lower (25 mL/kg per hour) intensity CRRT on antibiotic pharmacokinetics. METHODS: We collected serial blood samples to measure ciprofloxacin, meropenem, piperacillin-tazobactam, and vancomycin levels. We calculated extracorporeal clearance (CL), systemic CL, and volume of distribution (Vd) by non-linear mixed-effects modelling...
2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25777909/a-multicenter-study-on-the-effect-of-continuous-hemodiafiltration-intensity-on-antibiotic-pharmacokinetics
#4
Darren M Roberts, Xin Liu, Jason A Roberts, Priya Nair, Louise Cole, Michael S Roberts, Jeffrey Lipman, Rinaldo Bellomo
INTRODUCTION: Continuous renal replacement therapy (CRRT) may alter antibiotic pharmacokinetics and increase the risk of incorrect dosing. In a nested cohort within a large randomized controlled trial, we assessed the effect of higher (40 mL/kg/hour) and lower (25 mL/kg/hour) intensity CRRT on antibiotic pharmacokinetics. METHODS: We collected serial blood samples to measure ciprofloxacin, meropenem, piperacillin-tazobactam and vancomycin levels. We calculated extracorporeal clearance (CL), systemic CL and volume of distribution (Vd) by nonlinear mixed effects modelling...
December 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/24886826/%C3%AE-lactam-antibiotic-concentrations-during-continuous-renal-replacement-therapy
#5
Marjorie Beumier, Giuseppe Stefano Casu, Maya Hites, Lucie Seyler, Frederic Cotton, Jean-Louis Vincent, Frédérique Jacobs, Fabio Silvio Taccone
INTRODUCTION: The use of standard doses of β-lactam antibiotics during continuous renal replacement therapy (CRRT) may result in inadequate serum concentrations. The aim of this study was to evaluate the adequacy of unadjusted drug regimens (i.e., similar to those used in patients with normal renal function) in patients treated with CRRT and the influence of CRRT intensity on drug clearance. METHODS: We reviewed data from 50 consecutive adult patients admitted to our Department of Intensive Care in whom routine therapeutic drug monitoring (TDM) of broad-spectrum β-lactam antibiotics (ceftazidime or cefepime, CEF; piperacillin/tazobactam; TZP; meropenem, MEM) was performed using unadjusted β-lactam antibiotics regimens (CEF = 2 g q8h; TZP = 4 g q6h; MEM = 1 g q8h)...
May 22, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/23908259/population-pharmacokinetics-of-piperacillin-and-tazobactam-in-critically-ill-patients-undergoing-continuous-renal-replacement-therapy-application-to-pharmacokinetic-pharmacodynamic-analysis
#6
Eduardo Asín-Prieto, Alicia Rodríguez-Gascón, Iñaki F Trocóniz, Amaia Soraluce, Javier Maynar, José Ángel Sánchez-Izquierdo, Arantxazu Isla
OBJECTIVES: To evaluate the pharmacokinetics of piperacillin/tazobactam in critically ill patients undergoing continuous renal replacement therapy (CRRT) and to assess the success of the therapy against susceptible bacteria. PATIENTS AND METHODS: Sixteen patients undergoing CRRT with different degrees of renal function were included in the study. Blood and ultrafiltrate samples were drawn after administration of piperacillin/tazobactam (4/0.5 g) every 4, 6 or 8 h...
January 2014: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/23547902/drastic-reduction-of-piperacillin-tazobactam-concentrations-in-an-in-vitro-model-of-continuous-venovenous-hemofiltration-proposal-of-an-innovative-modality-of-administration-to-maintain-them-at-constant-concentration
#7
Michele Ferrannini, Pasquale Niscola, Clorinda Falcone, Annalisa Noce, Anna Pastore, Gianna Di Giovamberardino, Andrea Tendas, Laura Scaramucci, Nicola Di Daniele, Roberto Palumbo
BACKGROUND/AIMS: Critically-ill patients often undergo continuous renal replacement therapy (CRRT) and need antimicrobial therapy. Piperacillin and tazobactam (Pip-Tzb) are cleared by CRRT. Our aim is to evaluate Pip-Tzb removal in an in-vitro-single-pool-model of continuous-veno-venous-hemofiltration (CVVH); we test a new method of Pip-Tzb administration during CRRT assuring constant levels of concentrations above the minimum inhibitory concentration (MIC). METHODS: In an in-vitro-single-pool-model of CVVH, two solutions (Protein-Free-Solution, PFS and Fresh-Frozen- Plasma, FFP) added with Pip-Tzb were tested for Pip-Tzb removal and adsorption...
September 2013: Cardiovascular & Hematological Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/22282479/pharmacokinetics-and-pharmacodynamics-of-piperacillin-tazobactam-in-42-patients-treated-with-concomitant-crrt
#8
MULTICENTER STUDY
Seth R Bauer, Charbel Salem, Michael J Connor, Joseph Groszek, Maria E Taylor, Peilin Wei, Ashita J Tolwani, William H Fissell
BACKGROUND AND OBJECTIVES: Current recommendations for piperacillin-tazobactam dosing in patients receiving continuous renal replacement therapy originate from studies with relatively few patients and lower continuous renal replacement therapy doses than commonly used today. This study measured the pharmacokinetic and pharmacodynamic characteristics of piperacillin-tazobactam in patients treated with continuous renal replacement therapy using contemporary equipment and prescriptions. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A multicenter prospective observational study in the intensive care units of two academic medical centers was performed, enrolling patients with AKI or ESRD receiving piperacillin-tazobactam while being treated with continuous renal replacement therapy...
March 2012: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/21649882/recommended-%C3%AE-lactam-regimens-are-inadequate-in-septic-patients-treated-with-continuous-renal-replacement-therapy
#9
Lucie Seyler, Frédéric Cotton, Fabio Silvio Taccone, Daniel De Backer, Pascale Macours, Jean-Louis Vincent, Frédérique Jacobs
INTRODUCTION: Sepsis is responsible for important alterations in the pharmacokinetics of antibiotics. Continuous renal replacement therapy (CRRT), which is commonly used in septic patients, may further contribute to pharmacokinetic changes. Current recommendations for antibiotic doses during CRRT combine data obtained from heterogeneous patient populations in which different CRRT devices and techniques have been used. We studied whether these recommendations met optimal pharmacokinetic criteria for broad-spectrum antibiotic levels in septic shock patients undergoing CRRT...
2011: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/21115798/therapeutic-drug-monitoring-of-piperacillin-tazobactam-using-spent-dialysate-effluent-in-patients-receiving-continuous-venovenous-hemodialysis
#10
Michael J Connor, Charbel Salem, Seth R Bauer, Christina L Hofmann, Joseph Groszek, Robert Butler, Susan J Rehm, William H Fissell
Sepsis and multisystem organ failure are common diagnoses affecting nearly three-quarters of a million Americans annually. Infection is the leading cause of death in acute kidney injury, and the majority of critically ill patients who receive continuous dialysis also receive antibiotics. Dialysis equipment and prescriptions have gradually changed over time, raising concern that current drug dosing recommendations in the literature may result in underdosing of antibiotics. Our research group directed its attention toward antibiotic dosing strategies in patients with acute renal failure (ARF), and we sought data confirming that patients receiving continuous dialysis and antibiotics actually were achieving therapeutic plasma drug levels during treatment...
February 2011: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/16645266/elimination-of-piperacillin-and-tazobactam-by-renal-replacement-therapies-with-an69-and-polysulfone-hemofilters-evaluation-of-the-sieving-coefficient
#11
A Arzuaga, A Isla, A R Gascón, J Maynar, E Corral, J L Pedraz
BACKGROUND/AIM: Piperacillin-tazobactam is commonly used to treat infections in ICU patients. Controversial data have been published about the sieving/saturation coefficient (Sc/Sa) of piperacillin during continuous renal replacement therapies (CRRT). The objective was to evaluate the Sc/Sa of piperacillin-tazobactam during continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodialysis (CVVHD) using AN69 and polysulfone. METHODS: Ringer lactate, BSA-containing Ringer lactate and plasma were circulated at 150 ml/min...
2006: Blood Purification
https://www.readbyqxmd.com/read/16163635/antibiotic-dosing-in-critically-ill-adult-patients-receiving-continuous-renal-replacement-therapy
#12
REVIEW
Robin L Trotman, John C Williamson, D Matthew Shoemaker, William L Salzer
Continuous renal replacement therapy (CRRT) is now commonly used as a means of support for critically ill patients with renal failure. No recent comprehensive guidelines exist that provide antibiotic dosing recommendations for adult patients receiving CRRT. Doses used in intermittent hemodialysis cannot be directly applied to these patients, and antibiotic pharmacokinetics are different than those in patients with normal renal function. We reviewed the literature for studies involving the following antibiotics frequently used to treat critically ill adult patients receiving CRRT: vancomycin, linezolid, daptomycin, meropenem, imipenem-cilastatin, nafcillin, ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanic acid, cefazolin, cefotaxime, ceftriaxone, ceftazidime, cefepime, aztreonam, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin, colistin, amikacin, gentamicin, tobramycin, fluconazole, itraconazole, voriconazole, amphotericin B (deoxycholate and lipid formulations), and acyclovir...
October 15, 2005: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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