Abstract

 
 
 
 Purpose: To study the pharmacokinetics of piperacillin/tazobactam in renal replacement therapy (CRRT) in patients with chronic renal failure (CRF).
 Methods: Six CRF patients treated with CRRT in the First Affiliated Hospital of Hebei North University from April 2020 to July 2020 were selected and administered 4 g of piperacillin and 0.5 g of tazobactam within 30 min after, and at 5, 30, 45, 60, 90, 120, 180, 240, 360 and 480 min after CRRT. The DAS software was used to calculate pharmacokinetic parameters while linear regression was used to analyze the relationship among patient characteristics, CRRT parameters, and pharmacokinetics.
 Results: The Cmax of piperacillin and tazobactam was 118.46 (96.12 - 161.12) mg/L and 27.45 (14.75 - 28.45) mg/L, while the volume of distribution (Vd) was 1.16 (0.72 - 1.59) L/h and 0.72 (0.57 -0.82) L/kg, respectively. The value for elimination half-life (t1/2) was 4.66 (3.19 -8.45) h and 4.25 (3.42 - 5.96) h, while total clearance (CL) was 7.28 (5.58 - 9.73) L/h and 6.37 (4.28 - 10.04) L/h, respectively. Multivariate linear regression showed that piperacillin Cmax was negatively correlated with the flow velocity of the substitution fluid (β = -0.679, 95 % CI = -0.278 - 0.943, p < 0.001). Piperacillin CL was positively correlated with the flow velocity of the waste liquid (β = 0.956, 95 % CI = 1.267 - 4.796, p < 0.001).
 Conclusion: When used in CRF patients receiving CRRT, piperacillin and tazobactam show decrease in Cmax and CL, but increase in t1/2. This finding should provide useful guidance for clinicians concerned.
 
 
 
Highlights
Chronic renal failure, the terminal stage of chronic kidney disease, presents with obvious renal atrophy, and impairment of body functions such as excretion, acid-base balance and body fluid maintenance
This study analyzed the pharmacokinetic characteristics of piperacillin and tazobactam in patients with chronic renal failure receiving Continuous renal replacement therapy (CRRT), and investigated the associated influencing factors, with a view to providing a guide for clinical administration of these drugs
The included patients were: 1 patients with complete clinical data, aged 18 to 70 years; 2 patients who met the diagnostic criteria for chronic renal failure; 3 patients who satisfied CRRT indications; 4 those who had not used drugs containing piperacillin and tazobactam within 2 weeks before CRRT, and 5 patients who were aware of the study objectives, and volunteered as participants
Summary
The terminal stage of chronic kidney disease, presents with obvious renal atrophy, and impairment of body functions such as excretion, acid-base balance and body fluid maintenance. It is characterized by high incidence, severe complications, and poor prognosis [1,2]. Piperacillin and tazobactam are drugs frequently used in the treatment of chronic renal failure. This study analyzed the pharmacokinetic characteristics of piperacillin and tazobactam in patients with chronic renal failure receiving CRRT, and investigated the associated influencing factors, with a view to providing a guide for clinical administration of these drugs
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