ArticleThe Journal of antimicrobial chemotherapy2023
Relationship between piperacillin concentrations, clinical factors and piperacillin/tazobactam-associated acute kidney injury.
Article in The Journal of antimicrobial chemotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Population pharmacokinetics and dose optimization of piperacillin-tazobactam in premature and term neonates with severe infections.Antimicrobial agents and chemotherapy · 2026Article
- Development of population pharmacokinetic models of total and free piperacillin in critically ill children and young adults for Monte Carlo simulations and model-informed precision dosing.The Journal of antimicrobial chemotherapy · 2026Article
- Dose Optimization of Piperacillin for Pseudomonas aeruginosa Infection in Febrile Neutropenic Pediatric Patients.European journal of drug metabolism and pharmacokinetics · 2026Article
- Building a Beta-Lactam Model-Informed Precision Dosing Service in a Quaternary Care Children's Hospital.Clinical and translational science · 2025Review
- Piperacillin Sodium and Tazobactam Sodium-Induced Neutropenia and Thrombocytopenia: A Case Report.Clinical case reports · 2025Article
- Predictive Nomogram for Acute Kidney Injury Risk with Vancomycin and Piperacillin Tazobactam in Sepsis Treatment.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Model-informed dose optimization for prophylactic piperacillin-tazobactam in perioperative pediatric critically ill patients.Antimicrobial agents and chemotherapy · 2025Article
- Short, extended and continuous infusion of β-lactams: predicted impact on target attainment and risk for toxicity in an ICU patient cohort.The Journal of antimicrobial chemotherapy · 2025Article
- Piperacillin pharmacokinetics and pharmacodynamics in paediatric patients who received high frequency intra-operative piperacillin/tazobactam dosing.International journal of antimicrobial agents · 2024Article
- Association of piperacillin and vancomycin exposure on acute kidney injury during combination therapy.JAC-antimicrobial resistance · 2024Article
- Piperacillin/tazobactam treatment in children: evidence of subtherapeutic concentrations.Frontiers in pharmacology · 2024Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPiperacillin/tazobactam, a commonly used antibiotic, is associated with acute kidney injury (AKI). The relationship between piperacillin concentrations and AKI remains unknown.
objectiveEstimate piperacillin exposures in critically ill children and young adults administered piperacillin/tazobactam to identify concentrations and clinical factors associated with piperacillin-associated AKI. PATIENTS AND
methodsWe assessed piperacillin pharmacokinetics in 107 patients admitted to the paediatric ICU who received at least one dose of piperacillin/tazobactam. Piperacillin AUC, highest peak (Cmax) and highest trough (Cmin) in the first 24 hours of therapy were estimated. Piperacillin-associated AKI was defined as Kidney Disease: Improving Global Outcomes (KDIGO) Stage 2/3 AKI present >24 hours after initial piperacillin/tazobactam dose. Likelihood of piperacillin-associated AKI was rated using the Naranjo Adverse Drug Reaction Probability Scale. Multivariable logistic regression was performed to identify patient and clinical predictors of piperacillin-associated AKI.
resultsOut of 107 patients, 16 (15%) were rated as possibly or probably having piperacillin-associated AKI. Estimated AUC and highest Cmin in the first 24 hours were higher in patients with piperacillin-associated AKI (2042 versus 1445 mg*h/L, P = 0.03; 50.1 versus 10.7 mg/L, P < 0.001). Logistic regression showed predictors of piperacillin-associated AKI included higher Cmin (OR: 5.4, 95% CI: 1.7-23) and age (OR: 1.13, 95% CI: 1.05-1.25).
conclusionsWe show a relationship between estimated piperacillin AUC and highest Cmin in the first 24 hours of piperacillin/tazobactam therapy and piperacillin-associated AKI, suggesting total piperacillin exposure early in the course is associated with AKI development. These data could serve as the foundation for implementation of model-informed precision dosing to reduce AKI incidence in patients given piperacillin/tazobactam.
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