Piperacillin-tazobactam: Difference between revisions

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== Background ==
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==Background==
   
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=== Clinical Breakpoints ===
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===Clinical Breakpoints===
 
{| class="wikitable"
  
{| class="wikitable"
 
! rowspan="2" |Species
  
! rowspan="2" |Species
 
! rowspan="2" |ECV (μg/mL)
  
! rowspan="2" |ECV (μg/mL)
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! colspan="4" |Breakpoints (μg/mL)
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! colspan="3" |Breakpoints (μg/mL)
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! colspan="4" |Breakpoints (mm)
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! colspan="3" |Breakpoints (mm)
 
|-
  
|-
 
!S
  
!S
 
!I
  
!I
−
!SDD
  
 
!R
  
!R
 
!S
  
!S
 
!I
  
!I
−
!SDD
  
 
!R
  
!R
 
|-
  
|-
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|≤16/4
  
|≤16/4
 
|32/4-64/4
  
|32/4-64/4
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|—
  
 
|≥128/4
  
|≥128/4
 
|≥21
  
|≥21
 
|18-20
  
|18-20
−
|—
  
 
|≤17
  
|≤17
 
|-
  
|-
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|≤16/4
  
|≤16/4
 
|32/4-64/4
  
|32/4-64/4
−
|—
  
 
|≥128/4
  
|≥128/4
 
|≥21
  
|≥21
 
|15-20
  
|15-20
−
|—
  
 
|≤14
  
|≤14
 
|-
  
|-
−
|[[Acinetobacter species]]
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|[[Acinetobacter]]
 
|
  
|
 
|≤16/4
  
|≤16/4
 
|32/4-64/4
  
|32/4-64/4
−
|—
  
 
|≥128/4
  
|≥128/4
 
|≥21
  
|≥21
 
|18-20
  
|18-20
−
|—
  
 
|≤17
  
|≤17
 
|-
  
|-
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|≤16/4
  
|≤16/4
 
|32/4-64/4
  
|32/4-64/4
−
|—
  
 
|≥128/4
  
|≥128/4
⚫
|
  
 
|
  
|
 
|
  
|
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|≤16/4
  
|≤16/4
 
|32/4-64/4
  
|32/4-64/4
−
|—
  
 
|≥128/4
  
|≥128/4
⚫
|
  
 
|
  
|
 
|
  
|
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|
  
|
 
|≤1/4
  
|≤1/4
−
|—
  
 
|—
  
|—
 
|≥2/4
  
|≥2/4
 
|≥21
  
|≥21
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|—
  
 
|—
  
|—
 
|—
  
|—
 
|-
  
|-
 
|Gram-positive bacteria
  
|Gram-positive bacteria
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| colspan="9" |susceptibility predicted by [[penicillin]]
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| colspan="7" |susceptibility predicted by [[penicillin]]
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|}
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  +
== Dosing ==
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  +
* Standard dose: 3.375 g IV every 6 hours
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* [[Pseudomonas aeruginosa|Pseudomonas]] dose: 4.5 g IV every 6 hours
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  +
=== Renal Dosing ===
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{| class="wikitable"
  +
!CrCl
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!Standard
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![[Pseudomonas aeruginosa|Pseudomonas]]
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!Notes
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|-
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|>30
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|3.375 g q6h
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|4.5 g q6h
  ⚫
|
  +
|-
  +
|10-29
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|3.375 g q8h
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|4.5 g q8h
  ⚫
|
  +
|-
  +
|<10
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|3.375 g q12h
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|4.5 g q12h
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|
  +
|-
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|PD
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|3.375 g q12h
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|4.5 g q12h
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|
  +
|-
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|HD
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|3.375 g q12h
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|4.5 g q12h
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|On dialysis days, given towards the end of dialysis
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|-
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|CRRT
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|3.375 g q6h
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|4.5 g q6h
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|
  +
|-
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|SLED
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|3.375 g q12-18h
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|4.5 g q12-18h
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|Depends on severity of illness and intensity of SLED dialysis
 
|}
  
|}
 
[[Category:Β-lactams]]
  
[[Category:Β-lactams]]

Latest revision as of 11:07, 9 January 2024

Background

Clinical Breakpoints

Species ECV (μg/mL) Breakpoints (μg/mL) Breakpoints (mm)
S I R S I R
Enterobacterales ≤16/4 32/4-64/4 ≥128/4 ≥21 18-20 ≤17
Pseudomonas aeruginosa ≤16/4 32/4-64/4 ≥128/4 ≥21 15-20 ≤14
Acinetobacter ≤16/4 32/4-64/4 ≥128/4 ≥21 18-20 ≤17
Other non-Enterobacterales ≤16/4 32/4-64/4 ≥128/4
Anaerobes ≤16/4 32/4-64/4 ≥128/4
Haemophilus influenzae and Haemophilus parainfluenzae ≤1/4 — ≥2/4 ≥21 — —
Gram-positive bacteria susceptibility predicted by penicillin

Dosing

  • Standard dose: 3.375 g IV every 6 hours
  • Pseudomonas dose: 4.5 g IV every 6 hours

Renal Dosing

CrCl Standard Pseudomonas Notes
>30 3.375 g q6h 4.5 g q6h
10-29 3.375 g q8h 4.5 g q8h
<10 3.375 g q12h 4.5 g q12h
PD 3.375 g q12h 4.5 g q12h
HD 3.375 g q12h 4.5 g q12h On dialysis days, given towards the end of dialysis
CRRT 3.375 g q6h 4.5 g q6h
SLED 3.375 g q12-18h 4.5 g q12-18h Depends on severity of illness and intensity of SLED dialysis
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