Comparative Pharmacokinetic and Pharmacodynamic Profile of Piperacillin/Tazobactam 3.375G Q4H and 4.5G Q6H

@article{Mattoes2002ComparativePA,
  title={Comparative Pharmacokinetic and Pharmacodynamic Profile of Piperacillin/Tazobactam 3.375G Q4H and 4.5G Q6H},
  author={Holly M. Mattoes and Blair Capitano and Myo-Kyoung Kim and Dawei Xuan and Richard Quintiliani and Charles H. Nightingale and David P. Nicolau},
  journal={Chemotherapy},
  year={2002},
  volume={48},
  pages={59 - 63}
}
When piperacillin/tazobactam has been used to treat hospitalized patients with serious infections, including nosocomial pneumonia caused by Pseudomonas aeruginosa, it has usually been dosed at 3.375 g q4h to provide serum concentrations above commonly encountered organisms’ MICs (T > MIC) for at least 40–50% of the dosing interval. Pharmacodynamic principles suggest that a similar efficacy can be realized with extended dosing intervals when a larger dose (e.g. 4.5 g q6h) is administered, which… 

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References

SHOWING 1-10 OF 23 REFERENCES

Pharmacokinetics and pharmacodynamics of two multiple-dose piperacillin-tazobactam regimens

Inhibitory and bactericidal activities for the two regimens were determined with five American Type Culture Collection (ATCC) organisms (Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Bacteroides fragilis) and predicted measures of bactericidal and inhibitory activity were compared with measured AUBC0-24 and AUIC0- 24 values.

Rational Prescribing of Extended-Spectrum Penicillin β-Lactamase Inhibitor Combinations: Focus on Ticarcillin/Clavulanic Acid

  • M. Reed
  • Medicine, Biology
    The Annals of pharmacotherapy
  • 1998
Integration of pharmacokinetic and pharmacodynamic data is an appropriate means to assess/reassess dosing recommendations for antimicrobial agents.

Comparison of piperacillin vs. ticarcillin plus tobramycin in the treatment of acute pulmonary exacerbations of cystic fibrosis.

Single agent therapy has the advantage of providing reliable serum concentrations and, in contrast to the standard therapy, does not necessitate monitoring of serum drug concentrations.

Comparison of the bactericidal activities of piperacillin-tazobactam, ticarcillin-clavulanate, and ampicillin-sulbactam against clinical isolates of Bacteroides fragilis, Enterococcus faecalis, Escherichia coli, and Pseudomonas aeruginosa

The data suggest that use of shorter dosing intervals or continuous-infusion regimens should be considered in combination with an aminoglycoside to improve the bactericidal profiles of these agents for E. faecalis and P. aeruginosa.

Comparative dose-effect relations at several dosing intervals for beta-lactam, aminoglycoside and quinolone antibiotics against gram-negative bacilli in murine thigh-infection and pneumonitis models.

This paper evaluated the impact of dosing interval on the relative efficacy and potency of beta-lactams, aminoglycosides, and ciprofloxacin against Pseudomonas aeruginosa in murine pneumonitis and thigh-infection models.

Comparative antibiotic dose-effect relations at several dosing intervals in murine pneumonitis and thigh-infection models.

Compared the relative efficacy and potency of three beta-lactams and two aminoglycosides in lung and thigh-infection models in neutropenic mice by defining the maximum attainable antimicrobial effect at 24 h (Emax) and the total dose required to reach 50% of maximum effect (P50) at several dosing intervals.

Combined imipenem/cilastatin and tobramycin therapy of multiresistant Pseudomonas aeruginosa in cystic fibrosis.

Because of the rapid development of imipenem resistance despite combination therapy, the high proportion of side effects, and the risk of induction of beta-lactam resistance, imipanem/cilastatin cannot be recommended for routine treatment of CF-patients with P. aeruginosa infection.

Interactions of antimicrobial combinations in vitro: the relativity of synergism.

  • J. Blaser
  • Biology, Medicine
    Scandinavian journal of infectious diseases. Supplementum
  • 1990
The observed discrepancies between standard methods for testing drug interaction and a model which more closely reflects human pharmacokinetics support the argument that standard synergy testing provides incomplete data to reliably design clinical combination therapy.