Pharmacokinetics of piperacillin in critically ill Australian Indigenous patients with severe sepsis

Tsai, Danny, Stewart, Penelope, Goud, Rajendra, Gourley, Stephen, Hewagama, Saliya, Krishnaswamy, Sushena, Wallis, Steven C., Lipman, Jeffrey and Roberts, Jason A. (2016) Pharmacokinetics of piperacillin in critically ill Australian Indigenous patients with severe sepsis. Antimicrobial Agents and Chemotherapy, 60 12: 7402-7406. doi:10.1128/AAC.01657-16

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Author Tsai, Danny
Stewart, Penelope
Goud, Rajendra
Gourley, Stephen
Hewagama, Saliya
Krishnaswamy, Sushena
Wallis, Steven C.
Lipman, Jeffrey
Roberts, Jason A.
Title Pharmacokinetics of piperacillin in critically ill Australian Indigenous patients with severe sepsis
Journal name Antimicrobial Agents and Chemotherapy   Check publisher's open access policy
ISSN 1098-6596
0066-4804
Publication date 2016-12-01
Sub-type Article (original research)
DOI 10.1128/AAC.01657-16
Open Access Status File (Publisher version)
Volume 60
Issue 12
Start page 7402
End page 7406
Total pages 5
Place of publication Washington, DC, United States
Publisher American Society for Microbiology
Collection year 2017
Language eng
Formatted abstract
There are no available pharmacokinetic data to guide piperacillin dosing in critically ill Australian Indigenous patients despite numerous reported physiological differences. This study aimed to describe the population pharmacokinetics of piperacillin in critically ill Australian Indigenous patients with severe sepsis. A population pharmacokinetic study of Indigenous patients with severe sepsis was conducted in a remote hospital intensive care unit. Plasma samples were collected over two dosing intervals and assayed by validated chromatography. Population pharmacokinetic modeling was conducted using Pmetrics. Nine patients were recruited, and a two-compartment model adequately described the data. The piperacillin clearance (CL), volume of distribution of the central compartment (Vc), and distribution rate constants from the central to the peripheral compartment and from the peripheral to the central compartment were 5.6 ± 3.2 liters/h, 14.5 ± 6.6 liters, 1.5 ± 0.4 h-1, and 1.8 ± 0.9 h-1, respectively, where CL and Vc were found to be described by creatinine clearance (CLCR) and total body weight, respectively. In this patient population, piperacillin demonstrated high interindividual pharmacokinetic variability. CLCR was found to be the most important determinant of piperacillin pharmacokinetics.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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