Target attainment with continuous dosing of piperacillin/tazobactam in critical illness: a prospective observational study

Heleen Aardema, Prashant Nannan Panday, Mireille Wessels, Kay van Hateren, Jos G W Kosterink, Jan-Willem Alffenaar, Jan G Zijlstra, Willem Dieperink

Onderzoeksoutput: ArticleAcademicpeer review


Optimal dosing of β-lactam antibiotics in critically ill patients is a challenge given the unpredictable pharmacokinetic profile of this patient population. Several studies have shown intermittent dosing to often yield inadequate drug concentrations. Continuous dosing is an attractive alternative from a pharmacodynamic point of view. This study evaluated whether, during continuous dosing, piperacillin concentrations reached and maintained a pre-defined target in critically ill patients. Adult patients treated with piperacillin by continuous dosing in the intensive care unit of a university medical centre in The Netherlands were prospectively studied. Total and unbound piperacillin concentrations drawn at fixed time points throughout the entire treatment course were determined by liquid chromatography-tandem mass spectrometry. A pharmacokinetic combined target of a piperacillin concentration ≥80 mg/L, reached within 1 h of starting study treatment and maintained throughout the treatment course, was set. Eighteen patients were analysed. The median duration of monitored piperacillin treatment was 60 h (interquartile range, 33-96 h). Of the 18 patients, 5 (27.8%) reached the combined target; 15 (83.3%) reached and maintained a less strict target of >16 mg/L. In this patient cohort, this dosing schedule was insufficient to reach the pre-defined target. Depending on which target is to be met, a larger initial cumulative dose is desirable, combined with therapeutic drug monitoring.

Originele taal-2English
Pagina's (van-tot)68-73
Aantal pagina's6
TijdschriftInternational Journal of Antimicrobial Agents
Nummer van het tijdschrift1
StatusPublished - 1 jul. 2017
Extern gepubliceerdJa


  • continue toediening
  • kritieke zorg
  • Piperacillin
  • β-Lactam


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