Vol.59 No.4 July 2011
Dosage and administration schedule adjustment of tazobactam/piperacillin based on PK-PD analysis in patients with renal dysfunction
Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, Japan
Abstract
We estimated the optimal dosage and number of dosings of tazobactam/piperacillin(TAZ/PIPC) in patients with impaired renal function by simulating the relationship between the pharmacokinetics and the phamacodynamics(PK-PD) using the population pharmacokinetics(PPK) analysis based on the renal function, i.e., estimate value of creatinine clearance(Ccr), in Japanese patients with community-acquired pneumonia.
For patients with sepsis and pneumonia or patients with severe pyelonephritis and complicated cystitis, the recommended dose is 2.25 g administered thrice daily or 4.5 g administered twice daily when the Ccr is between 10 and 40 mL/min. On the other hand, for patients with sepsis and pneumonia in whom the Ccr is less than 10 mL/min, the recommended dose is 2.25 g twice a day.
For patients with very severe or intractable pneumonia, the dose of 4.5 g administered thrice daily is recommended in patients when the Ccr is between 20 and 40 mL/min. When the Ccr is between 10 and 20 mL/min, and less than 10 mL/min, the recommended doses are 2.25 g administered four times daily or 4.5 g administered three times daily, and 2.25 g administered four times daily or 4.5 g administered twice daily, respectively.
For patients with less severe pyelitis and complex cystitis, the recommended dose is 2.25 g administered twice daily when the Ccr is between 10 and 40 mL/min.
Key word
tazobactam/piperacillin, renal dysfunction, PK-PD
Received
March 10, 2011
Accepted
May 16, 2011
Jpn. J. Chemother. 59 (4): 359-365, 2011
