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Erschienen in:
01.05.2004 | Brief Report
Steady-state plasma and intrapulmonary concentrations of piperacillin/tazobactam 4 g/0.5 g administered to critically ill patients with severe nosocomial pneumonia
Erschienen in: Intensive Care Medicine | Ausgabe 5/2004
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Objective
To determine the steady-state plasma and epithelial lining fluid (ELF) concentrations of piperacillin/tazobactam (P/T) administered to critically ill patients with severe bacterial pneumonia.
Design
Prospective, open-label study.
Setting
An intensive care unit and research ward in a university hospital.
Patients
Ten adult patients with severe nosocomial bacterial pneumonia on mechanical ventilation.
Interventions
All subjects received a 30-min intravenous infusion of P/T 4 g/0.5 g every 8 h. The steady-state plasma and ELF concentrations of P/T were determined by high-performance liquid chromatography.
Measurements and main results
The mean±SD steady-state plasma trough, peak, and intermediate concentrations were 8.5±4.6 µg/ml, 55.9±21.6 µg/ml, and 24.0±13.8 µg/ml for piperacillin, and 2.1±1.0 µg/ml, 4.8±2.1 µg/ml, and 2.4±1.2 µg/ml for tazobactam, respectively. The mean±SD steady-state intermediate ELF concentrations were 13.6±9.4 µg/ml for piperacillin and 2.1±1.1 µg/ml for tazobactam, respectively, showing a mean percentage penetration of piperacillin and tazobactam into ELF of 56.8% and 91.3 %, respectively, with a P/T ratio of 6.5:1.
Conclusion
Our results show that during the treatment of severe nosocomial pneumonia, a regimen of P/T 4 g/0.5 g every 8 h might provide insufficient concentrations into lung tissue to exceed the MIC of many causative pathogens. This suggests that higher doses of P/T should be administered in order to maximize the antibiotic concentration at the site of infection, or that a second antimicrobial agent should be used in association.