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

Michele Ferrannini, Pasquale Niscola, Clorinda Falcone, Annalisa Noce, Anna Pastore, Gianna Di Giovamberardino, Andrea Tendas, Laura Scaramucci, Nicola Di Daniele, Roberto Palumbo

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)187-193
Number of pages7
JournalCardiovascular and Hematological Agents in Medicinal Chemistry
Volume11
Issue number3
DOIs
Publication statusPublished - 2013

Fingerprint

Hemofiltration
Renal Replacement Therapy
Microbial Sensitivity Tests
Adsorption
In Vitro Techniques
tazobactam drug combination piperacillin
Critical Illness

Keywords

  • Antibiotic
  • Antimicrobial therapy
  • Continuous renal replacement therapy
  • Continuous venovenous hemofiltration
  • Drug clearance
  • Dyalisis
  • In vitro investigation
  • Infection
  • Minimum inhibitory concentration (MIC)
  • Piperacillin
  • Sepsis
  • Tazobactam

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Hematology
  • Pharmacology

Cite this

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. / Ferrannini, Michele; Niscola, Pasquale; Falcone, Clorinda; Noce, Annalisa; Pastore, Anna; Di Giovamberardino, Gianna; Tendas, Andrea; Scaramucci, Laura; Di Daniele, Nicola; Palumbo, Roberto.

In: Cardiovascular and Hematological Agents in Medicinal Chemistry, Vol. 11, No. 3, 2013, p. 187-193.

Research output: Contribution to journalArticle

Ferrannini, Michele ; Niscola, Pasquale ; Falcone, Clorinda ; Noce, Annalisa ; Pastore, Anna ; Di Giovamberardino, Gianna ; Tendas, Andrea ; Scaramucci, Laura ; Di Daniele, Nicola ; Palumbo, Roberto. / 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. In: Cardiovascular and Hematological Agents in Medicinal Chemistry. 2013 ; Vol. 11, No. 3. pp. 187-193.
@article{abd576e0ffb549b38e4c4f0ddd163243,
title = "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",
abstract = "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.",
keywords = "Antibiotic, Antimicrobial therapy, Continuous renal replacement therapy, Continuous venovenous hemofiltration, Drug clearance, Dyalisis, In vitro investigation, Infection, Minimum inhibitory concentration (MIC), Piperacillin, Sepsis, Tazobactam",
author = "Michele Ferrannini and Pasquale Niscola and Clorinda Falcone and Annalisa Noce and Anna Pastore and {Di Giovamberardino}, Gianna and Andrea Tendas and Laura Scaramucci and {Di Daniele}, Nicola and Roberto Palumbo",
year = "2013",
doi = "10.2174/187152571103140120102359",
language = "English",
volume = "11",
pages = "187--193",
journal = "Cardiovascular and Hematological Agents in Medicinal Chemistry",
issn = "1871-5257",
publisher = "Bentham Science Publishers B.V.",
number = "3",

}

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

UR - http://www.scopus.com/inward/record.url?scp=84892967651&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892967651&partnerID=8YFLogxK

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 -