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. 2014 Jun;58(6):3533-7.
doi: 10.1128/AAC.02340-14. Epub 2014 Mar 31.

Altered pharmacokinetics of piperacillin in febrile neutropenic patients with hematological malignancy

Fekade Bruck Sime  1 , Michael S Roberts  2 , Morgyn S Warner  3 , Uwe Hahn  4 , Thomas A Robertson  2 , Sue Yeend  5 , Andy Phay  5 , Sheila Lehman  4 , Jeffrey Lipman  6 , Sandra L Peake  7 , Jason A Roberts  8
Affiliations

Altered pharmacokinetics of piperacillin in febrile neutropenic patients with hematological malignancy

Fekade Bruck Sime et al. Antimicrob Agents Chemother. 2014 Jun.

Abstract

This study assessed the pharmacokinetics and dosing adequacy of piperacillin in febrile neutropenic patients after the first dose. Pharmacokinetic analysis was performed using noncompartmental methods. We observed an elevated volume of distribution (29.7 ± 8.0 liters [mean ± standard deviation]) and clearance (20.2 ± 7.5 liters/h) compared to data from other patient populations. Antibiotic exposure did not consistently result in therapeutic targets. We conclude that alternative dosing strategies guided by therapeutic drug monitoring may be required to optimize exposure.

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Figures

FIG 1
FIG 1
Plasma concentration-time profile for total piperacillin concentration after a single dose of 4.5 g piperacillin-tazobactam in 12 febrile neutropenic patients with hematological malignancies.
FIG 2
FIG 2
Pharmacodynamic target attainment after a single dose of 4.5 g piperacillin-tazobactam in 12 febrile neutropenic patients with hematological malignancies (considering EUCAST MIC breakpoints for Enterobacteriaceae and P. aeruginosa).
See this image and copyright information in PMC

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