Pharmacokinetic analysis and Monte Cado simulation of piperacillin in patients on intermittent hemodialysis

Thep harmacokineticosf a standardtr eatmentr egimeno f piperacillihna ven everb eend escribedfo r hospitalizepda tientso n chronicin termittenht emodialysisS.i ngled oses tudiesin otherwiseh ealthy volunteersh aves hownt hat thisp atientp opulationh asa prolongedh alf-lifea nda reau ndert he curvea s well asd ecreasecdl earanceT. hiss tudyw ill enroll1 0 hospitalizepda tientsw ith chronick idneyd isease on intermittenth emodialyswish o arer eceiving2.25gqm8 ho f piperacillin/tazobactaOmu. ro bjectives aret o characterizteh e pharmacokinetpica rameterosf thisa genti n thisp atientp opulationa ndt hent o performa MonteC arlos imulationto determineth e expectedp harmacokinetic/pharmacodynamic targeta ttainmenta gainsbt acteriaw ith a rangeo f MlCs.S ubjectws ill be includedif they havec hronic kidneyd iseaser,e ceivein termittenht emodialysfios r at least6 months,a ndh avea documentedo r suspectedin fection.E xclusiocnr iteriain clude< 18y earso f age,c oncomitanlti verd iseasep, regnancyo,r historyo f allergyto penicillinosr cephalosporinsB.l oods amplesw ill bec ollectedo n inter-dialysdisa ys immediatelyb eforea doseo f piperacillin/tazobactaamnd, t hen3 0 minutes!,, 2,4, and8 hoursa fter the infusionis s tarted.A dditionabl loods amplesw ill be collectedim mediatelby eforea nd L houra ftera dialysis essionS. amplews ill be analyzedfo r piperacillicno ncentrationuss ingh igh-pressurlieq uid chromatographyT.h ep opulationp harmacokinetpica rameterws ill then be usedi n a 10,000p atient MonteC arlos imulationth at will evaluateth e probabilittyh at a targett ime greatert han MICo f 50%i s achievedo vera rangeo f MlCs.T hee xpectedo utcomei st hat this recommendeddo singr egimenis appropriatefo r organismws ith an MICs 16mcg/mLo wingt o the similaritieosf thisp opulation's piperacillicno ncentration-timceu rvet o an extendedin fusionr egimenin individualws ith normalr enal fu nction.