TY - JOUR
T1 - Drastic reduction of piperacillin-tazobactam concentrations in an in-vitro model of continuous venovenous hemofiltration
T2 - Proposal of an innovative modality of administration to maintain them at constant concentration
AU - Ferrannini, Michele
AU - Niscola, Pasquale
AU - Falcone, Clorinda
AU - Noce, Annalisa
AU - Pastore, Anna
AU - Di Giovamberardino, Gianna
AU - Tendas, Andrea
AU - Scaramucci, Laura
AU - Di Daniele, Nicola
AU - Palumbo, Roberto
PY - 2013
Y1 - 2013
N2 - 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. Then, to keep concentrations constantly above the MIC during CVVH, we add Pip-Tzb in the reinfusion bags. Results: Pip-Tzb rapidly decreased than the MIC during CVVH. The adsorption was irrelevant in the test with FPS. Adding Pip-Tzb in the reinfusion bags of the CVVH system, we observed constant concentrations of Pip-Tzb over time. Conclusion: The association of Pip-Tzb is rapidly cleared with a real risk of inadequate dosages in patients undergoing CRRT. Adding Pip-Tzb in the reinfusion bags above the MIC, we obtained stability of concentrations during CVVH.
AB - 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. Then, to keep concentrations constantly above the MIC during CVVH, we add Pip-Tzb in the reinfusion bags. Results: Pip-Tzb rapidly decreased than the MIC during CVVH. The adsorption was irrelevant in the test with FPS. Adding Pip-Tzb in the reinfusion bags of the CVVH system, we observed constant concentrations of Pip-Tzb over time. Conclusion: The association of Pip-Tzb is rapidly cleared with a real risk of inadequate dosages in patients undergoing CRRT. Adding Pip-Tzb in the reinfusion bags above the MIC, we obtained stability of concentrations during CVVH.
KW - Antibiotic
KW - Antimicrobial therapy
KW - Continuous renal replacement therapy
KW - Continuous venovenous hemofiltration
KW - Drug clearance
KW - Dyalisis
KW - In vitro investigation
KW - Infection
KW - Minimum inhibitory concentration (MIC)
KW - Piperacillin
KW - Sepsis
KW - Tazobactam
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U2 - 10.2174/187152571103140120102359
DO - 10.2174/187152571103140120102359
M3 - Article
C2 - 23547902
AN - SCOPUS:84892967651
VL - 11
SP - 187
EP - 193
JO - Cardiovascular and Hematological Agents in Medicinal Chemistry
JF - Cardiovascular and Hematological Agents in Medicinal Chemistry
SN - 1871-5257
IS - 3
ER -