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首页> 外文期刊>Journal of pharmacy practice >Simplifying Piperacillin/Tazobactam Dosing: Pharmacodynamics of Utilizing Only 4.5 or 3.375 g Doses for Patients With Normal and Impaired Renal Function
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Simplifying Piperacillin/Tazobactam Dosing: Pharmacodynamics of Utilizing Only 4.5 or 3.375 g Doses for Patients With Normal and Impaired Renal Function

机译：简化哌啶蛋白/ Tazobactam给药：用于肾功能正常和受损的患者的仅使用4.5或3.375g剂量的药效学

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Objectives: To evaluate the pharmacodynamic exposure of piperacillin/tazobactam across the renal function range using 4.5 or 3.375 g dosing regimens. Methods: A 5000-patient Monte Carlo simulation was conducted to determine the probability of achieving 50% free time above the minimum inhibitory concentration (fT > MIC) for piperacillin. Proposed regimens, using solely 4.5 or 3.375 g strengths, were compared with regimens listed in piperacillin/tazobactam prescribing information over creatinine clearance (CrCl) ranges of 120 mL/min to hemodialysis. The probability of target attainment (PTA) at MICs < 16 ug/mL was compared between proposed and standard regimens. Results: At CrCI 41 to 120 mL/min, prolonged infusions of 4.5 g (3 hours) and 3.375 g (4 hours) every 6 hours resulted in >95% PTA versus >76% for standard regimens (0.5 hour). At CrCI 20 to 40 mL/min, 4.5 and 3.375 g every 8 hours as prolonged infusions achieved slightly higher PTA (≥98%) versus standard regimens (≥93%). Similarly, PTA achieved with prolonged infusions of 4.5 and 3.375 g every 12 hours (≥93%) was comparable with those of standard regimens (≥91%) at CrCI 1 to 19 mL/min. In hemodialysis, 100% PTA was achieved with prolonged infusion regimens. Conclusion: Piperacillin/tazobactam regimens designed around the 4.5 or 3.375 g dose and prolonged infusions provided similar or better PTA at MICs ≤ 16 ug/mL compared with standard regimens. These observations may support the stocking and use of a single piperacillin/tazobactam strength to simplify dosing.
机译：目的：使用4.5或3.375g给药方案评估哌啶/塔沙漠酰胺哌啶/塔沙漠酰胺的药效流学性暴露。方法：进行5000患者蒙特卡罗模拟以确定哌啶素最低抑制浓度（FT> MIC）以上实现50％的空闲时间的可能性。将拟议的方案，使用单独的4.5或3.375g强度与哌啶蛋白/塔扎酰胺例中列出的肌酐清除（CRCL）的方案进行比较120ml / min至血液透析。在提出的和标准方案之间比较了MICS <16ug / mL的靶培养（PTA）的概率。结果：在CRCI 41至120毫升/分钟，延长输注4.5g（3小时）和3.375克（4小时）每6小时导致标准方案（0.5小时）> 76％> 76％。在CRCI 20至40ml / min，每8小时4.5和3.375克，延长输注略高于PTA（≥98％）与标准方案（≥93％）。类似地，每12小时（≥93％）每12小时（≥93％）延长输注的PTA与CRCI 1至19mL / min的标准方案（≥91％）相当。在血液透析中，通过延长的输注方案实现100％PTA。结论：哌啶蛋白/ Tazobactam围绕4.5或3.375g的方案，与标准方案相比，在MICS≤16ug/ ml时提供相似或更好的PTA。这些观察结果可支持单一哌啶/唑唑胺强度的放养和使用以简化给药。

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