Wulkersdorfer, Beatrix and Bergmann, Felix and Amann, Lisa and Fochtmann-Frana, Alexandra and Al Jalali, Valentin and Kurdina, Elizaveta and Lackner, Edith and Wicha, Sebastian G. and Dorn, Christoph and Schaefer, Bruno and Ihra, Gerald and Rath, Thomas and Radtke, Christine and Zeitlinger, Markus (2024) Effect of albumin substitution on pharmacokinetics of piperacillin/tazobactam in patients with severe burn injury admitted to the ICU. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 79 (2). pp. 262-270. ISSN 0305-7453, 1460-2091
Full text not available from this repository. (Request a copy)Abstract
Background Pathophysiological changes in severely burned patients alter the pharmacokinetics (PK) of anti-infective agents, potentially leading to subtherapeutic concentrations at the target site. Albumin supplementation, to support fluid resuscitation, may affect pharmacokinetic properties by binding drugs. This study aimed to investigate the PK of piperacillin/tazobactam in burn patients admitted to the ICU before and after albumin substitution as total and unbound concentrations in plasma.Patients and methods Patients admitted to the ICU and scheduled for 4.5 g piperacillin/tazobactam administration and 200 mL of 20% albumin substitution as part of clinical routine were included. Patients underwent IV microdialysis, and simultaneous arterial plasma sampling, at baseline and multiple timepoints after drug administration. PK analysis of total and unbound drug concentrations under steady-state conditions was performed before and after albumin supplementation.Results A total of seven patients with second- to third-degree burns involving 20%-60% of the total body surface were enrolled. Mean (SD) AUC0-8 (h center dot mg/L) of total piperacillin/tazobactam before and after albumin substitution were 402.1 (242)/53.2 (27) and 521.8 (363)/59.7 (32), respectively. Unbound mean AUC0-8 before and after albumin supplementation were 398.9 (204)/54.5 (25) and 456.4 (439)/64.5 (82), respectively.Conclusions Albumin supplementation had little impact on the PK of piperacillin/tazobactam. After albumin supplementation, there was a numerical increase in mean AUC0-8 of total and unbound piperacillin/tazobactam, whereas similar Cmax values were observed. Future studies may investigate the effect of albumin supplementation on drugs with a higher plasma protein binding.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PROTEIN-BINDING; CLINICAL PHARMACOKINETICS; MICRODIALYSIS; ANTIBIOTICS; MANAGEMENT; INFECTION; PLASMA |
| Subjects: | 600 Technology > 610 Medical sciences Medicine 600 Technology > 615 Pharmacy |
| Divisions: | Chemistry and Pharmacy > Institute of Pharmacy > Group Clinical Pharmacy (Dr. Dorn) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 08 May 2024 10:25 |
| Last Modified: | 11 Mar 2025 10:13 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60569 |
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