Comparison of the pharmacokinetics of piperacillin and sulbactam during intermittent.pdf

Fax +41 61 306 12 34 E-Mail karger@karger.ch Pharmacology Chemotherapy 2007;53:370–377 DOI: 10.1159/000107725 Comparison of the Pharmacokinetics of Piperacillin and Sulbactam during Intermittent and Continuous Intravenous Infusion J. Langgartner a N. Lehn b T. Glück a H. Herzig a F. Kees c a Department of Internal Medicine I, b Institute of Medical Microbiology and Hygiene, and c Department of Pharmacology, University of Regensburg, Regensburg , Germany 212 8 109 ml/min); (4) half-life: piperacillin 2.4 8 1.2 h, sul- bactam 3.1 8 1.6 h. Steady-state concentrations during CI were 25.5 8 14.5 mg/l for piperacillin and 8.0 8 3.7 mg/l for sulbactam. Average serum concentrations were comparable in both regimens. Conclusion: A large German survey dem- onstrated that approximately 89% of Pseudomonas aeru- gionsa have an MIC ? 16 mg/l and approximately 82% have an MIC ? 8 mg/l. According to this threshold, appropriate anti-bacterial concentrations of piperacillin/sulbactam were achievable with CI. CI dosing has the additional advantage that less drug is necessary. Further prospective studies are warranted to compare the clinical efficacy of CI and SI regi- mens in bacterial infections. Copyright ? 2007 S. Karger AG, Basel Introduction Antibiotics can be divided into two groups according to their mode of action. Antibiotics in the first group, e.g. aminoglycosides and fluoroquinolones, exhibit concen- tration-dependent activity. This means that their rate of killing increases for concentrations above 5 times the minimum inhibitory concentration (MIC). The second group with  -lactams as the major representatives shows Key Words Piperacillin  Sulbactam  High-performance liquid chromatography   -Lactam antibiotics  Time-dependent antibacterial activity   -Lactamase inhibitor  Pharmacokinetics Abstract Background: The antibacterial effect of piperacillin/sulbac- tam dep