%0 Journal Article %1 Reese2005 %A Reese, Alicia M. %A Frei, Christopher R. %A Burgess, David S. %D 2005 %J Int J Antimicrob Agents %K drug drugresistance dosing betalactamases %N 2 %P 114--119 %R 10.1016/j.ijantimicag.2005.06.004 %T Pharmacodynamics of intermittent and continuous infusion piperacillin/tazobactam and cefepime against extended-spectrum beta-lactamase-producing organisms. %U http://dx.doi.org/10.1016/j.ijantimicag.2005.06.004 %V 26 %X The pharmacodynamics of piperacillin/tazobactam and cefepime were evaluated against extended-spectrum beta-lactamase (ESBL)-producing organisms. Ten thousand patients were simulated based on ESBL minimum inhibitory concentrations (MICs) from our laboratory (N=39) and on pharmacokinetic data from peer-reviewed literature. The desired proportion of the dosing interval that the concentration remains above the MIC (\%T>MIC) for the intermittent bolus regimens was >/=40\% for piperacillin/tazobactam and >/=60\% for cefepime. The desired C(ss)/MIC ratio (where C(ss) is the concentration at steady state) was >/=2 for all continuous infusion (CI) regimens. MIC(50), MIC(90) and \%S were, respectively, 64/4mug/mL, 1024/4mug/mL and 33\% for piperacillin/tazobactam and 8mug/mL, 16mug/mL and 0\% for cefepime. For piperacillin/tazobactam, 3.375g every 4h (q4h) achieved the highest probability of target attainment (43\%), followed by 13.5g CI (31\%), 3.375g q6h (27\%), 4.5g q8h (17\%) and 6.75g CI (10\%). However, for cefepime, 4g CI had the highest probability of target attainment (77\%), followed by 1g q8h (65\%), 2g q12h (58\%), 3g CI (46\%) and 1g q12h (27\%). Although the probabilities of target attainment for cefepime were higher than for piperacillin/tazobactam, neither agent achieved a high probability of target attainment and should not be used routinely for the treatment of ESBL infections.

@article{Reese2005, abstract = {The pharmacodynamics of piperacillin/tazobactam and cefepime were evaluated against extended-spectrum beta-lactamase (ESBL)-producing organisms. Ten thousand patients were simulated based on ESBL minimum inhibitory concentrations (MICs) from our laboratory (N=39) and on pharmacokinetic data from peer-reviewed literature. The desired proportion of the dosing interval that the concentration remains above the MIC (\%T>MIC) for the intermittent bolus regimens was >/=40\% for piperacillin/tazobactam and >/=60\% for cefepime. The desired C(ss)/MIC ratio (where C(ss) is the concentration at steady state) was >/=2 for all continuous infusion (CI) regimens. MIC(50), MIC(90) and \%S were, respectively, 64/4mug/mL, 1024/4mug/mL and 33\% for piperacillin/tazobactam and 8mug/mL, 16mug/mL and 0\% for cefepime. For piperacillin/tazobactam, 3.375g every 4h (q4h) achieved the highest probability of target attainment (43\%), followed by 13.5g CI (31\%), 3.375g q6h (27\%), 4.5g q8h (17\%) and 6.75g CI (10\%). However, for cefepime, 4g CI had the highest probability of target attainment (77\%), followed by 1g q8h (65\%), 2g q12h (58\%), 3g CI (46\%) and 1g q12h (27\%). Although the probabilities of target attainment for cefepime were higher than for piperacillin/tazobactam, neither agent achieved a high probability of target attainment and should not be used routinely for the treatment of ESBL infections.}, added-at = {2013-02-28T02:58:41.000+0100}, author = {Reese, Alicia M. and Frei, Christopher R. and Burgess, David S.}, biburl = {https://www.bibsonomy.org/bibtex/2d461eb28b54af6683edf0ae779fbfe6f/aorchid}, doi = {10.1016/j.ijantimicag.2005.06.004}, file = {:ID_General/IntlJAntimicrobAgents.26.114_cef_pip_infusionesbl.pdf:PDF}, groups = {public}, institution = {Division of Pharmacotherapy, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.}, interhash = {b072eb57d88f3049394f49ab0efb986a}, intrahash = {d461eb28b54af6683edf0ae779fbfe6f}, journal = {Int J Antimicrob Agents}, keywords = {drug drugresistance dosing betalactamases}, language = {eng}, medline-pst = {ppublish}, month = Aug, number = 2, pages = {114--119}, pii = {S0924-8579(05)00167-6}, pmid = {16029947}, timestamp = {2013-02-28T02:58:41.000+0100}, title = {Pharmacodynamics of intermittent and continuous infusion piperacillin/tazobactam and cefepime against extended-spectrum beta-lactamase-producing organisms.}, url = {http://dx.doi.org/10.1016/j.ijantimicag.2005.06.004}, username = {aorchid}, volume = 26, year = 2005 }