Tsai, Danny

Stewart, Penny

Goud, Rajendra

Gourley, Stephen

Hewagama, Saliya

Krishnaswamy, Sushena

Wallis, Steven C

Lipman, Jeffrey

Roberts, Jason A

2016

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.

Burns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia d.tsai@uq.edu.au.. Department of Intensive Care Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.. Pharmacy Department, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..

Department of Intensive Care Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..

Department of Intensive Care Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..

Emergency Department, Alice Springs Hospital, Alice Springs, Northern Territory, Australia..

Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.. Department of Infectious Diseases, The Northern Hospital, Epping, Melbourne, Victoria, Australia..

Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.. Monash Infectious Diseases, Monash Health, Clayton, Melbourne, Victoria, Australia..

Burns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia..

Burns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.. Department of Intensive Care Medicine, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia..

Burns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.. Department of Intensive Care Medicine, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.. School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia..

Antimicrobial agents and chemotherapy 2016; 60(12): 7402-7406

0000-0002-7059-8808

https://pubmed.ncbi.nlm.nih.gov/27736759/?otool=iaurydwlib

https://hdl.handle.net/10137/5314

APACHE

Adult

Anti-Bacterial Agents

Body Weight

Creatinine

Critical Illness

Female

Humans

Intensive Care Units

Male

Microbial Sensitivity Tests

Middle Aged

Piperacillin

Sepsis

Oceanic Ancestry Group

Pharmacokinetics of Piperacillin in Critically Ill Australian Indigenous Patients with Severe Sepsis.

Journal Article

Publication