| Research Article: | Piperacillin-tazobactam dosing in anuric acute kidney injury patients receiving continuous renal replacement therapy |
| Author: | Dhakrit Rungkitwattanakul, Taniya Charoensareerat, Ekanong Chaichoke, Thanakorn Rakamthong, Pitchaya Srisang, Sutthiporn Pattharachayakul, Nattachai Srisawat & Weerachai Chaijamorn |
| Email: | taniya.cha@siam.edu ; weerachai.cha@siam.edu |
| Department|Faculty: | Faculty of Pharmacy, Siam University, Bangkok 10160 |
| Published: | Seminars in Dialysis, 2023, 20 February 2023, Pages 1-9 https://doi.org/10.1111/sdi.13148 |
Citation
Rungkitwattanakul D., Charoensareerat T., Chaichoke E., Rakamthong T., Srisang P., Pattharachayakul S., Srisawat N., Chaijamorn W. (2023). Piperacillin-tazobactam dosing in anuric acute kidney injury patients receiving continuous renal replacement therapy. Seminars in Dialysis, 1-9. https://doi.org/10.1111/sdi.13148
ABSTRACT
Introduction: To determine appropriate dosing of piperacillin-tazobactam in critically ill patients receiving continuous renal replacement therapy (CRRT).
Methods: The databases of PubMed, Embase, and ScienceDirect were searched. We used the Medical Subject Headings of “piperacillin-tazobactam,” “CRRT,” and “pharmacokinetics” or related terms or synonym to identify the studies for reviews. A one-compartment pharmacokinetic model was conducted to predict piperacillin levels for the initial 48 h of therapy. The pharmacodynamic target was 50% of free drug level above the minimum inhibitory concentration (MIC) and 4 times of the MIC. The dose that achieved at least 90% of the probability of target attainment was defined as an optimal dose.
Results: Our simulation study reveals that the dosing regimen of piperacillin-tazobactam 12 g/day is appropriate for treating Pseudomonal infection with KDIGO recommended effluent rate of 25–35 mL/kg/h. The MIC values of each setting were an important factor to design piperacillin-tazobactam dosing regimens.
Conclusion: The Monte Carlo simulation can be a useful tool to evaluate drug dosing in critically ill acute kidney injury patients receiving CRRT when limited pharmacokinetic data are a concern. Clinical validation of these results is needed.
Piperacillin-tazobactam dosing in anuric acute kidney injury patients receiving continuous renal replacement therapy
Faculty of Pharmacy, Siam University, Bangkok, Thailand