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Piperacillin/tazobactam, renal replacement

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https://www.readbyqxmd.com/read/27784223/does-piperacillin-tazobactam-increase-the-risk-of-nephrotoxicity-when-used-with-vancomycin-a-meta-analysis-of-observational-trials
#1
Joseph P Rindone, Chadwick Mellen, Jennifer Ryba
BACKGROUND: Observational studies have suggested an increased risk of nephrotoxicity when piperacillin-tazobactam is added to vancomycin, although the data are confliciting. OBJECTIVE: To perform a meta-analysis of identified studies to assess if adding piperacillin-tazobactam to vancomycin increases the incidence of nephrotoxicity. METHOD: A systematic review of PubMed, EMBASE, Cochrane Central, and Google Scholar was conducted to identify studies...
October 24, 2016: Current Drug Safety
https://www.readbyqxmd.com/read/27054905/is-high-dose-%C3%AE-lactam-therapy-associated-with-excessive-drug-toxicity-in-critically-ill-patients
#2
Craig McDonald, Menino O Cotta, Peter J Little, Brett McWhinney, Jacobus P Ungerer, Jeffrey Lipman, Jason A Roberts
BACKGROUND: β-lactam antibiotics may necessitate higher than licensed drug doses to achieve therapeutic exposures in critically ill patients. Therapeutic drug monitoring can be used to guide dosing so as to maximise therapeutic effect whilst reducing the likelihood of exposure-related toxicity. METHODS: A retrospective review of critically ill patients identified those that received higher than licensed doses of either meropenem (3-6 g/day) or piperacillin-tazobactam (16 g-2 g/day) (i...
September 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27039986/piperacillin-concentration-in-relation-to-therapeutic-range-in-critically-ill-patients-a-prospective-observational-study
#3
Johannes Zander, Gundula Döbbeler, Dorothea Nagel, Barbara Maier, Christina Scharf, Mikayil Huseyn-Zada, Jette Jung, Lorenz Frey, Michael Vogeser, Michael Zoller
BACKGROUND: Piperacillin levels after standard dosing have been shown frequently to be subtherapeutic, especially when renal clearance was augmented. Here, we aimed to determine if piperacillin was in its therapeutic range in a typically heterogeneous intensive care unit patient group, and also to describe target attainment dependent on daily dosage, creatinine clearance, and renal replacement therapy (RRT). METHODS: Sixty patients with severe infections were included in this monocentric prospective observational study...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26952639/comparative-incidence-of-acute-kidney-injury-in-critically-ill-patients-receiving-vancomycin-with-concomitant-piperacillin-tazobactam-or-cefepime-a-retrospective-cohort-study
#4
Drayton A Hammond, Melanie N Smith, Jacob T Painter, Nikhil K Meena, Katherine Lusardi
STUDY OBJECTIVE: The combination of vancomycin and piperacillin-tazobactam has been associated with an increased risk of acute kidney injury (AKI) in non-critically ill patient populations, but it is still unknown if this association exists in critically ill patients. The objective of this study was to compare the incidence of AKI development during therapy or within 72 hours after completion of therapy in adult critically ill patients who received vancomycin with concomitant piperacillin-tazobactam or cefepime...
May 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/26932762/sampling-antibiotics-in-renal-replacement-therapy-smarrt-an-observational-pharmacokinetic-study-in-critically-ill-patients
#5
MULTICENTER STUDY
Jason A Roberts, Gordon Y S Choi, Gavin M Joynt, Sanjoy K Paul, Renae Deans, Sandra Peake, Louise Cole, Dianne Stephens, Rinaldo Bellomo, John Turnidge, Steven C Wallis, Michael S Roberts, Darren M Roberts, Melissa Lassig-Smith, Therese Starr, Jeffrey Lipman
BACKGROUND: Optimal antibiotic dosing is key to maximising patient survival, and minimising the emergence of bacterial resistance. Evidence-based antibiotic dosing guidelines for critically ill patients receiving RRT are currently not available, as RRT techniques and settings vary greatly between ICUs and even individual patients. We aim to develop a robust, evidence-based antibiotic dosing guideline for critically ill patients receiving various forms of RRT. We further aim to observe whether therapeutic antibiotic concentrations are associated with reduced 28-day mortality...
March 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/26916045/-urosepsis-in-geriatric-patients
#6
H J Heppner, F Yapan, A Wiedemann
Due to the demographic shift, increasing numbers of geriatric patients are admitted to acute care hospitals of all levels of care. This means that special challenges must be met in the medical care and management of these patients.Immunosenescence and multimorbidity make elderly patients vulnerable to infectious diseases. Urinary tract infections range from "simple" cystitis to pyelonephritis and urosepsis and, at 25%, are the second most common form of infection in geriatric patients. It is often difficult to make a diagnosis because typical symptoms do not always occur...
February 2016: Aktuelle Urologie
https://www.readbyqxmd.com/read/26499505/survey-of-pharmacists%C3%A2-antibiotic-dosing-recommendations-for-sustained-low-efficiency-dialysis
#7
Jian P Mei, Azadeh Ali-Moghaddam, Bruce A Mueller
BACKGROUND: The use of hybrid renal replacement therapies like sustained low efficiency dialysis (SLED) is increasing in ICUs worldwide. However, pharmacokinetic studies designed to inform therapeutic antibiotic dosing in critically ill patients receiving SLED are limited. SLED operational characteristics vary across institutions. Pharmacists in institutions that utilize SLED are challenged to recommend therapeutic doses for antibiotics. OBJECTIVE: To characterize pharmacist-recommended antibiotic regimens for SLED...
February 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/26134359/%C3%AE-d-glucan-and-candida-albicans-germ-tube-antibody-in-icu-patients-with-invasive-candidiasis
#8
Estrella Martín-Mazuelos, Ana Loza, Carmen Castro, Desirée Macías, Ismail Zakariya, Pedro Saavedra, Sergio Ruiz-Santana, Elena Marín, Cristóbal León
PURPOSE: To assess the performance of (1→3)-β-D-glucan (BDG) and Candida albicans germ tube antibody (CAGTA) for the diagnosis of invasive candidiasis (IC) in a prospective cohort of 107 unselected, non-neutropenic ICU patients. METHODS: BDG (cutoff positivity ≥80 pg/mL) and CAGTA (cutoff positivity ≥1/160) assays were performed twice a week. Confounding factors included amoxicillin-clavulanate and piperacillin-tazobactam treatments, recent surgery, Gram-positive bloodstream infection, renal replacement therapy, and enteral nutrition...
August 2015: Intensive Care Medicine
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
#9
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/25987247/amoxicillin-plus-temocillin-as-an-alternative-empiric-therapy-for-the-treatment-of-severe-hospital-acquired-pneumonia-results-from-a-retrospective-audit
#10
H Habayeb, B Sajin, K Patel, C Grundy, A Al-Dujaili, S Van de Velde
A formulary decision was made at a large provider of acute hospital services in Surrey to replace piperacillin/tazobactam with amoxicillin+temocillin for the empiric treatment of severe hospital-acquired pneumonia. This decision was made because the use of broad-spectrum-β-lactam antibiotics is a known risk factor for Clostridium difficile infection (CDI) and for the selection of resistance. After the antibiotic formulary was changed, a retrospective audit was conducted to assess the effect of this change...
August 2015: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/25958400/gram-negative-bacteraemia-in-haemodialysis
#11
Eleanor C Murray, Aleksandra Marek, Peter C Thomson, John E Coia
BACKGROUND: Patients on renal replacement therapy experience higher rates of morbidity and mortality, infection being the second commonest cause of death. In our haemodialysis population, we identify the pathogens, sensitivity patterns, sources of infection and outcomes of Gram-negative bacteraemia. METHODS: Data from the NHS Greater Glasgow & Clyde and NHS Forth Valley haemodialysis population were collected July 2011 to April 2014 through an interrogation of the renal unit electronic patient record, and confirmed by an independent search of the Microbiology database...
July 2015: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/25881576/a-multicenter-study-on-the-effect-of-continuous-hemodiafiltration-intensity-on-antibiotic-pharmacokinetics
#12
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
#13
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/25632974/are-standard-doses-of-piperacillin-sufficient-for-critically-ill-patients-with-augmented-creatinine-clearance
#14
Andrew A Udy, Jeffrey Lipman, Paul Jarrett, Kerenaftali Klein, Steven C Wallis, Kashyap Patel, Carl M J Kirkpatrick, Peter S Kruger, David L Paterson, Michael S Roberts, Jason A Roberts
INTRODUCTION: The aim of this study was to explore the impact of augmented creatinine clearance and differing minimum inhibitory concentrations (MIC) on piperacillin pharmacokinetic/pharmacodynamic (PK/PD) target attainment (time above MIC (fT>MIC)) in critically ill patients with sepsis receiving intermittent dosing. METHODS: To be eligible for enrolment, critically ill patients with sepsis had to be receiving piperacillin-tazobactam 4.5 g intravenously (IV) by intermittent infusion every 6 hours for presumed or confirmed nosocomial infection without significant renal impairment (defined by a plasma creatinine concentration greater than 171 μmol/L or the need for renal replacement therapy)...
2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25098503/piperacillin-tazobactam-induced-neurotoxicity-in-a-hemodialysis-patient-a-case-report
#15
Precil Diego M M Neves, Fernanda M Freitas, Christiane A Kojima, Beatriz L Carmello, Rodrigo Bazan, Pasqual Barretti, Luis C Martin
Antibiotics are potentially a cause of neurotoxicity in dialysis patients, the most common are the beta-lactams as ceftazidime and cefepime, and few cases have been reported after piperacillin/tazobactam use. This report presents a case of a hypertensive and diabetic 67-year-old woman in regular hemodialysis, which previously had a stroke. She was hospitalized presenting pneumonia, which was initially treated with cefepime. Two days after treatment, she presented dysarthria, left hemiparesis, ataxia, and IX and X cranial nerves paresis...
January 2015: Hemodialysis International
https://www.readbyqxmd.com/read/24886826/%C3%AE-lactam-antibiotic-concentrations-during-continuous-renal-replacement-therapy
#16
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
#17
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
#18
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/23301534/evaluation-of-antibiotic-prescribing-patterns-in-patients-receiving-sustained-low-efficiency-dialysis-opportunities-for-pharmacists
#19
Laura E Harris, Anne B Reaves, Amy G Krauss, Justin Griner, Joanna Q Hudson
OBJECTIVES: Sustained low-efficiency dialysis (SLED) is a 'hybrid' form of continuous renal replacement therapy; however, there is very limited information on drug disposition during this procedure. Individuals requiring SLED are often critically ill and require antibiotics. The study aim was to evaluate antibiotic orders for patients requiring SLED compared to literature-based recommendations. We also evaluated whether doses were administered as prescribed and assessed clinical and microbiologic cure...
February 2013: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/23147743/case-control-study-of-drug-monitoring-of-%C3%AE-lactams-in-obese-critically-ill-patients
#20
Maya Hites, Fabio Silvio Taccone, Fleur Wolff, Frédéric Cotton, Marjorie Beumier, Daniel De Backer, Sandrine Roisin, Sophie Lorent, Rudy Surin, Lucie Seyler, Jean-Louis Vincent, Frédérique Jacobs
Severe sepsis and septic shock can alter the pharmacokinetics of broad-spectrum β-lactams (meropenem, ceftazidime/cefepime, and piperacillin-tazobactam), resulting in inappropriate serum concentrations. Obesity may further modify the pharmacokinetics of these agents. We reviewed our data on critically ill obese patients (body mass index of ≥ 30 kg/m(2)) treated with a broad-spectrum β-lactam in whom therapeutic drug monitoring was performed and compared the data to those obtained in critically nonobese patients (body mass index of <25 kg/m(2)) to assess whether there were differences in reaching optimal drug concentrations for the treatment of nosocomial infections...
February 2013: Antimicrobial Agents and Chemotherapy
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