[Pharmacokinetics and therapeutic monitoring of piperacillin/tazobactam]. 2020

Veronika Kubíčková, and Karel Urbánek
Department of Pharmacology, Faculty of Medicine and Dentistry in Olomouc, e-mail: karel.urbanek@upol.cz.

Given their wide therapeutic index, beta-lactam antibiotics are commonly used to treat critically ill patients. It is in these patients that significant heterogeneity in pharmacokinetics was noted, compared to the population average, especially in the volume of distribution, drug clearance and biological half-life, with values increasing as much as two-fold or, in the case of biological half-life, as much as four-fold. Significant pharmacokinetic changes also occur in cases of morbid obesity or renal insufficiency and when complex surgical techniques such as extracorporeal circulation are used. Therapeutic monitoring of piperacillin/tazobactam is a way to personalize and optimize therapy for these groups of patients. Preclinical data show a correlation between the probability of therapeutic success and concentrations of the unbound fraction of an antibiotic exceeding the minimum inhibitory concentration (MIC) for 40-50 % of the dosing interval. This time appears to be the preferred pharmacodynamic target for beta-lactam antibiotics. In critically ill patients, however, an even higher target may be required, ideally 100 % fT > 4xMIC. A better pharmacodynamic profile can be obtained using prolonged or continuous infusion. The biggest obstacle to routine TDM in β-lactams is the speed of quality sample determination. Currently, the most widely used method of measuring plasma concentrations is liquid chromatography coupled with UV or MS detection.

UI MeSH Term Description Entries
D008826 Microbial Sensitivity Tests Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses). Bacterial Sensitivity Tests,Drug Sensitivity Assay, Microbial,Minimum Inhibitory Concentration,Antibacterial Susceptibility Breakpoint Determination,Antibiogram,Antimicrobial Susceptibility Breakpoint Determination,Bacterial Sensitivity Test,Breakpoint Determination, Antibacterial Susceptibility,Breakpoint Determination, Antimicrobial Susceptibility,Fungal Drug Sensitivity Tests,Fungus Drug Sensitivity Tests,Sensitivity Test, Bacterial,Sensitivity Tests, Bacterial,Test, Bacterial Sensitivity,Tests, Bacterial Sensitivity,Viral Drug Sensitivity Tests,Virus Drug Sensitivity Tests,Antibiograms,Concentration, Minimum Inhibitory,Concentrations, Minimum Inhibitory,Inhibitory Concentration, Minimum,Inhibitory Concentrations, Minimum,Microbial Sensitivity Test,Minimum Inhibitory Concentrations,Sensitivity Test, Microbial,Sensitivity Tests, Microbial,Test, Microbial Sensitivity,Tests, Microbial Sensitivity
D010878 Piperacillin Semisynthetic, broad-spectrum, AMPICILLIN derived ureidopenicillin antibiotic proposed for PSEUDOMONAS infections. It is also used in combination with other antibiotics. AB-Piperacillin,Cl-227193,Pipcil,Pipera-Hameln,Piperacillin Curasan,Piperacillin Fresenius,Piperacillin Hexal,Piperacillin Monosodium Salt,Piperacillin Sodium,Piperacillin-Ratiopharm,Pipercillin,Pipracil,Pipril,T-1220,T1220,AB Piperacillin,Cl 227193,Cl227193,Curasan, Piperacillin,Monosodium Salt, Piperacillin,Pipera Hameln,Piperacillin Ratiopharm,Salt, Piperacillin Monosodium,Sodium, Piperacillin,T 1220
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077725 Piperacillin, Tazobactam Drug Combination An antibiotic combination product of piperacillin and tazobactam, a penicillanic acid derivative with enhanced beta-lactamase inhibitory activity, that is used for the intravenous treatment of intra-abdominal, pelvic, and skin infections and for community-acquired pneumonia of moderate severity. It is also used for the treatment of PSEUDOMONAS AERUGINOSA INFECTIONS. Piperacillin - Tazobactam,Piperacillin-Tazobactam Combination Product,Pipercillin Sodium - Tazobactam Sodium,Pipercillin Sodium, Tazobactam Sodium Drug Combination,Tazocel,Tazocillin,Tazocin,Zosyn,Piperacillin Tazobactam,Piperacillin Tazobactam Combination Product,Pipercillin Sodium Tazobactam Sodium,Tazobactam, Piperacillin -
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D047090 beta-Lactams Four-membered cyclic AMIDES, best known for the PENICILLINS based on a bicyclo-thiazolidine, as well as the CEPHALOSPORINS based on a bicyclo-thiazine, and including monocyclic MONOBACTAMS. The BETA-LACTAMASES hydrolyze the beta lactam ring, accounting for BETA-LACTAM RESISTANCE of infective bacteria. beta-Lactam,4-Thia-1-Azabicyclo(3.2.0)Heptanes,4-Thia-1-Azabicyclo(4.2.0)Octanes,beta Lactam,beta Lactams

Related Publications

Veronika Kubíčková, and Karel Urbánek
October 1994, The Journal of toxicological sciences,
Veronika Kubíčková, and Karel Urbánek
October 1994, The Journal of toxicological sciences,
Veronika Kubíčková, and Karel Urbánek
January 1993, The Journal of antimicrobial chemotherapy,
Veronika Kubíčková, and Karel Urbánek
May 2004, International journal of antimicrobial agents,
Veronika Kubíčková, and Karel Urbánek
January 1995, Pharmacotherapy,
Veronika Kubíčková, and Karel Urbánek
July 2018, Clinica chimica acta; international journal of clinical chemistry,
Veronika Kubíčková, and Karel Urbánek
January 2005, International journal of antimicrobial agents,
Veronika Kubíčková, and Karel Urbánek
January 2023, Clinical pharmacokinetics,
Veronika Kubíčková, and Karel Urbánek
June 2013, European journal of clinical pharmacology,
Veronika Kubíčková, and Karel Urbánek
November 1997, Antimicrobial agents and chemotherapy,
Copied contents to your clipboard!