The effect of piperacillin dose on elimination kinetics in renal impairment

@article{Aronoff2004TheEO,
  title={The effect of piperacillin dose on elimination kinetics in renal impairment},
  author={George R. Aronoff and Rebecca S. Sloan and Michael E. Brier and Friedrich C. Luft},
  journal={European Journal of Clinical Pharmacology},
  year={2004},
  volume={24},
  pages={543-547}
}
SummaryThe effect of drug dose on piperacillin elimination kinetics was examined in 27 adult subjects with varying renal function. Piperacillin, 15 mg/kg or 60 mg/kg, was given by bolus intravenous injection. The elimination half-life (t1/2) increased five-fold and plasma clearance (Clp) decreased by 80% in patients with renal failure. Both parameters were dose dependent in patients with normal renal function, but not in patients with renal insufficiency. Piperacillin dose dependent elimination… 

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References

SHOWING 1-10 OF 13 REFERENCES

Mezlocillin dose dependent elimination kinetics in renal impairment

TLDR
Elimination was not prolonged by increasing the dose in subjects with normal renal function, but elimination kinetics were dose dependent in anuric patients.

PHARMACOKINETICS OF PIPERACILLIN IN RENAL FAILURE

Patients with chronic renal failure who received bolus doses of piperacillin maintained high serum levels for up to six hours. The percentage of the injected dose which was detectable in the urine in

Pharmacokinetics of piperacillin in patients with moderate renal failure and in patients undergoing hemodialysis

TLDR
The pharmacokinetics of piperacillin administered intravenously were studied in patients with stable mild to moderate renal impairment and in five patients undergoing hemodialysis, implying significant nonrenal elimination.

Dose dependence of piperacillin pharmacokinetics.

TLDR
The results document that piperacillin is subject to dose-dependent pharmacokinetics and Capacity-limited kinetics is a property shared by other ureidopenicillins.

Piperacillin: Human Pharmacokinetics After Intravenous and Intramuscular Administration

TLDR
Probenecid (1 g given orally before administration of piperacillin) increased peak serum concentration, terminal serum half-life, and the area under the plasma concentration curve by 60%, and it decreased the apparent distribution volume and the renal clearance of the intramuscularly administered antibiotic by 40%.

Incidence and natural history of chemically defined varicella-zoster virus hepatitis in children and adolescents.

TLDR
It is concluded that chemically defined VZV hepatitis is an infrequent, self-limiting complication of chickenpox in otherwise healthy children and adolescents.

Piperacillin, a new penicillin active against many bacteria resistant to other penicillins

  • K. FuH. Neu
  • Biology, Medicine
    Antimicrobial Agents and Chemotherapy
  • 1978
The in vitro activity of piperacillin, a new semisynthetic piperazine penicillin derivative, was evaluated against 626 clinical isolates and compared with the activity of other beta-lactam

In Vitro and In Vivo Antibacterial Activity of T-1220, a New Semisynthetic Penicillin

TLDR
T-1220 is a new semisynthetic penicillin derivative that possesses a broad spectrum of in vitro antibacterial activity against gram-positive and gram-negative bacteria and is more effective than carbenicillin (CB-PC) against Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus species, and Serratia marcescens.

Piperacillin pharmacokinetics in subjects with chronic renal failure

TLDR
A dose of 70 mg/kg or a dose of 4 g appears to provide adequate serum concentrations against susceptible organisms for a 12-h interval, and no adverse reactions were noted in any subject throughout the study.

Biliary concentrations of piperacillin in patients undergoing cholecystectomy

TLDR
The biliary excretion of piperacillin was studied in patients undergoing cholecystectomy with marked activity against Pseudomonas aeruginosa and no correlation occurred with peak serum level of antibiotic, creatinine, bilirubin, or alkaline phosphatase.