| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Chemotherapy | ||||
| Publisher: | KARGER | ||||
| Place of Publication: | BASEL | ||||
| Volume: | 53 | ||||
| Number of Issue or Book Chapter: | 5 | ||||
| Page Range: | pp. 370-377 | ||||
| Date: | 2007 | ||||
| Institutions: | Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene Chemistry and Pharmacy > Institute of Pharmacy > Alumni or Retired Professors > Prof. Wiegrebe | ||||
| Identification Number: |
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| Keywords: | COMPLICATED INTRAABDOMINAL INFECTION; BETA-LACTAM ANTIBIOTICS; CYSTIC-FIBROSIS; HEALTHY-VOLUNTEERS; TAZOBACTAM; PHARMACODYNAMICS; CEFTAZIDIME; EFFICACY; PHARMACOECONOMICS; COMBINATION; piperacillin; sulbactam; high-performance liquid; chromatography; beta-lactam antibiotics; time-dependent antibacterial activity; beta-lactamase inhibitor; pharmacokinetics | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine 600 Technology > 615 Pharmacy | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 69499 |
Web of ScienceAbstract
Background: The antibacterial effect of piperacillin/sulbactam depends on the time of drug concentration above the minimal inhibitory concentration (MIC). Therefore, continuous infusion (Cl) may be a more rational approach than standard intermittent short-term infusion (SI). The study investigated whether Cl achieves effective drug concentrations comparable with SI. Methods: Seven intensive care ...
Abstract
Background: The antibacterial effect of piperacillin/sulbactam depends on the time of drug concentration above the minimal inhibitory concentration (MIC). Therefore, continuous infusion (Cl) may be a more rational approach than standard intermittent short-term infusion (SI). The study investigated whether Cl achieves effective drug concentrations comparable with SI. Methods: Seven intensive care unit patients received either piperacillin/sulbactam as 4/1 g intravenous infusion over 15 -20 min every 8 h or as 4/1 g intravenous loading dose (15 -20 min) followed by 8/2 g intravenous Cl per 24 h. After 2 days, regimes were crossed over. Results: Pharmacokinetic parameters (mean +/- SD) for Sl piperacillin/ sulbactam were: (1) peak serum concentration: piperacillin 231 +/- 66 mg/l, sulbactam 53.1 +/- 15.0 mg/l; (2) minimum serum concentration: piperacillin 11.5 +/- 14.8 mg/l, sulbactam 4.2 +/- 3.5 mg/l; (3) clearance: piperacillin 197 +/- 72 ml/ min (C 269 +/- 123 ml/min), sulbactam 167 +/- 61 ml/min (Cl 212 +/- 109 ml/min); (4) half-life: piperacillin 2.4 +/- 1.2 h, sulbactam 3.1 +/- 8 1.6 h. Steady-state concentrations during Cl were 25.5 +/- 14.5 mg/l for piperacillin and 8.0 +/- 3.7 mg/l for sulbactam. Average serum concentrations were comparable in both regimens. Conclusion: A large German survey demonstrated that approximately 89% of Pseudomonas aerugionsa have an MIC <= 16 mg/l and approximately 82% have an MIC <= 8 mg/l. According to this threshold, appropriate anti-bacterial concentrations of piperacillin/sulbactam were achievable with Cl. Cl dosing has the additional advantage that less drug is necessary. Further prospective studies are warranted to compare the clinical efficacy of Cl and Sl regimens in bacterial infections. Copyright (C) 2007 S. Karger AG, Basel.
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