Kinetics of galactomannan in surgical patients receiving perioperative piperacillin/tazobactam prophylaxis

M. Machetti, M. J. Majabo, E. Furfaro, N. Solari, A. Novelli, F. Cafiero, C. Viscoli

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives: The association between piperacillin/tazobactam and the positivity of the galactomannan (GM) detection ELISA test is well described. Little information is available about the kinetics of GM in patients treated with piperacillin/tazobactam. The present study aimed at clarifying the baseline interaction between piperacillin/tazobactam and GM in patients receiving this drug. Patients and methods: Seven patients undergoing abdominal surgery received perioperative prophylaxis with piperacillin/tazobactam. Each patient received three doses of 4.5 g of the drug, administered at 8 h intervals (one before and two after surgery). Three patients received antibiotic batches with 'medium' (GM-index = 1.782) and four patients received antibiotic batches with 'high' (GM-index = 6.665) GM content. Serum samples for GM evaluation were collected before drug infusion and at times +1, +3, +6 and +8 h after the first and third infusions. Results: GM levels increased after infusion, in particular when batches with 'high' GM content were used. Moreover, a non-statistically significant increase between the first dose and the third dose was observed. All samples taken >6 h after administration were negative (GM-index <0.2), both with the 'medium' and the 'high' GM content batches. Conclusions: The low content of GM 8 h after piperacillin/tazobactam infusion suggests that in non-neutropenic cancer patients with solid tumours receiving up to three doses of piperacillin/tazobactam, serum sampling for GM detection should be performed immediately before the next piperacillin/tazobactam administration.

Original languageEnglish
Pages (from-to)806-810
Number of pages5
JournalJournal of Antimicrobial Chemotherapy
Volume58
Issue number4
DOIs
Publication statusPublished - Oct 15 2006

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tazobactam drug combination piperacillin
galactomannan
Pharmaceutical Preparations
Anti-Bacterial Agents
Serum
Neoplasms
Enzyme-Linked Immunosorbent Assay

Keywords

  • Antigen detection false positives
  • Diagnosis interactions
  • Fungal infections

ASJC Scopus subject areas

  • Microbiology
  • Pharmacology

Cite this

Kinetics of galactomannan in surgical patients receiving perioperative piperacillin/tazobactam prophylaxis. / Machetti, M.; Majabo, M. J.; Furfaro, E.; Solari, N.; Novelli, A.; Cafiero, F.; Viscoli, C.

In: Journal of Antimicrobial Chemotherapy, Vol. 58, No. 4, 15.10.2006, p. 806-810.

Research output: Contribution to journalArticle

Machetti, M. ; Majabo, M. J. ; Furfaro, E. ; Solari, N. ; Novelli, A. ; Cafiero, F. ; Viscoli, C. / Kinetics of galactomannan in surgical patients receiving perioperative piperacillin/tazobactam prophylaxis. In: Journal of Antimicrobial Chemotherapy. 2006 ; Vol. 58, No. 4. pp. 806-810.
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abstract = "Objectives: The association between piperacillin/tazobactam and the positivity of the galactomannan (GM) detection ELISA test is well described. Little information is available about the kinetics of GM in patients treated with piperacillin/tazobactam. The present study aimed at clarifying the baseline interaction between piperacillin/tazobactam and GM in patients receiving this drug. Patients and methods: Seven patients undergoing abdominal surgery received perioperative prophylaxis with piperacillin/tazobactam. Each patient received three doses of 4.5 g of the drug, administered at 8 h intervals (one before and two after surgery). Three patients received antibiotic batches with 'medium' (GM-index = 1.782) and four patients received antibiotic batches with 'high' (GM-index = 6.665) GM content. Serum samples for GM evaluation were collected before drug infusion and at times +1, +3, +6 and +8 h after the first and third infusions. Results: GM levels increased after infusion, in particular when batches with 'high' GM content were used. Moreover, a non-statistically significant increase between the first dose and the third dose was observed. All samples taken >6 h after administration were negative (GM-index <0.2), both with the 'medium' and the 'high' GM content batches. Conclusions: The low content of GM 8 h after piperacillin/tazobactam infusion suggests that in non-neutropenic cancer patients with solid tumours receiving up to three doses of piperacillin/tazobactam, serum sampling for GM detection should be performed immediately before the next piperacillin/tazobactam administration.",
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AU - Majabo, M. J.

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AU - Solari, N.

AU - Novelli, A.

AU - Cafiero, F.

AU - Viscoli, C.

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N2 - Objectives: The association between piperacillin/tazobactam and the positivity of the galactomannan (GM) detection ELISA test is well described. Little information is available about the kinetics of GM in patients treated with piperacillin/tazobactam. The present study aimed at clarifying the baseline interaction between piperacillin/tazobactam and GM in patients receiving this drug. Patients and methods: Seven patients undergoing abdominal surgery received perioperative prophylaxis with piperacillin/tazobactam. Each patient received three doses of 4.5 g of the drug, administered at 8 h intervals (one before and two after surgery). Three patients received antibiotic batches with 'medium' (GM-index = 1.782) and four patients received antibiotic batches with 'high' (GM-index = 6.665) GM content. Serum samples for GM evaluation were collected before drug infusion and at times +1, +3, +6 and +8 h after the first and third infusions. Results: GM levels increased after infusion, in particular when batches with 'high' GM content were used. Moreover, a non-statistically significant increase between the first dose and the third dose was observed. All samples taken >6 h after administration were negative (GM-index <0.2), both with the 'medium' and the 'high' GM content batches. Conclusions: The low content of GM 8 h after piperacillin/tazobactam infusion suggests that in non-neutropenic cancer patients with solid tumours receiving up to three doses of piperacillin/tazobactam, serum sampling for GM detection should be performed immediately before the next piperacillin/tazobactam administration.

AB - Objectives: The association between piperacillin/tazobactam and the positivity of the galactomannan (GM) detection ELISA test is well described. Little information is available about the kinetics of GM in patients treated with piperacillin/tazobactam. The present study aimed at clarifying the baseline interaction between piperacillin/tazobactam and GM in patients receiving this drug. Patients and methods: Seven patients undergoing abdominal surgery received perioperative prophylaxis with piperacillin/tazobactam. Each patient received three doses of 4.5 g of the drug, administered at 8 h intervals (one before and two after surgery). Three patients received antibiotic batches with 'medium' (GM-index = 1.782) and four patients received antibiotic batches with 'high' (GM-index = 6.665) GM content. Serum samples for GM evaluation were collected before drug infusion and at times +1, +3, +6 and +8 h after the first and third infusions. Results: GM levels increased after infusion, in particular when batches with 'high' GM content were used. Moreover, a non-statistically significant increase between the first dose and the third dose was observed. All samples taken >6 h after administration were negative (GM-index <0.2), both with the 'medium' and the 'high' GM content batches. Conclusions: The low content of GM 8 h after piperacillin/tazobactam infusion suggests that in non-neutropenic cancer patients with solid tumours receiving up to three doses of piperacillin/tazobactam, serum sampling for GM detection should be performed immediately before the next piperacillin/tazobactam administration.

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KW - Fungal infections

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