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Pharmacokinetic/Pharmacodynamic Modeling of Antibiotics
Published in Hartmut Derendorf, Günther Hochhaus, Handbook of Pharmacokinetic/Pharmacodynamic Correlation, 2019
Arno Nolting, Hartmut Derendorf
The pharmacodynamic parameters obtained from Equation 15 were k0, 0.0235 ± 0.0102 min−1; ki′, 0.0262 ± 0.0803 min−1; and the Michaelis-Menten-type saturation constant, Km, was 0.0547 ± 0.1088 mg/ml. The authors concluded that the antimicrobial activity could be mathematically described by the proposed model. Three constants, k0, Km, and ki, were able to describe sufficiently the antimicrobial activity of the antibiotic. The model was also capable of predicting both microbial death and regrowth as a function of time after single-dose administration of piperacillin.
Mezlocillin, Azlocillin, Apalcillin, and Piperacillin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Adrian Tramontana, Karin Thursky
Similar to mezlocillin, piperacillin can be used to treat severe infections caused by sensitive Gram-negative aerobic and anaerobic bacteria with the benefit of avoiding the toxicity of aminoglycoside therapy (Winston et al., 1980; Pancoast et al., 1981; Gooding et al., 1982).
Successful treatment with amoxicillin-clavulanic acid: cutaneous nocardiosis caused by Nocardia brasiliensis
Published in Journal of Dermatological Treatment, 2023
Youqi Ji, Fang Su, Xin Hong, Mengyuan Chen, Yongze Zhu, Dongqing Cheng, Yumei Ge
After admission, the patient was given anti-infective treatment with piperacillin tazobactam 4.5 g intravenously, 3 times a day for 8 days. And debridement and surface disinfection of skin lesions. On day 8 of hospitalization, we changed the antibiotic to intravenous amoxicillin clavulanic acid 1.2 g twice a day for 5 days. The lesion gradually diminished in size, permitting discharge on the 13th hospital day, followed by continued oral amoxicillin-clavulanic acid 312.5 mg three times a day for another 8 days after discharge. The total duration of antibiotic treatment was 21 days. The ulcer gradually peeled and crusted, leaving dark pigmentation (Figure 1(B)). After discharge, we suggest that the patient come back to our hospital for reexamination one month and give rehabilitation training guidance. Within one week, the patient should have a proper rest, lower limb elevation, and a small amount of indoor activities. After one week, the patient can resume normal activities if there is no obvious discomfort. Avoid strenuous exercise for 2 weeks. Avoid standing for long periods of time and heavy physical work for one month.
Pharmacokinetics of antibiotics for pleural infection
Published in Expert Review of Respiratory Medicine, 2022
Estee P M Lau, Calvinjit Sidhu, Natalia D Popowicz, Y. C. Gary Lee
In clinical practice, there is variability in antibiotic selection and duration of treatment. In the Multicenter Intrapleural Sepsis Trial (MIST)-1 randomized trial [26], intravenous cefuroxime and metronidazole, followed by oral amoxicillin/clavulanic acid were recommended as the empirical treatment for community acquired infection, while intravenous imipenem or meropenem (or cefuroxime for empyema complicating thoracic surgery) was recommended for hospital acquired infection. Antibiotic therapy was continued for 3 weeks. In MIST-2 [27], amoxicillin/clavulanic acid, metronidazole, cephalosporins and macrolides (not routinely recommended by the BTS guideline) were most commonly used and continued for a minimum of two weeks and up to one month if needed. Additionally, our dose de-escalation series reported piperacillin/tazobactam, amoxicillin/clavulanate acid and meropenem as the most commonly used antibiotics and the duration of antibiotic therapy was approximately 28 days including 12–16 days of intravenous antibiotic days [57,58].
Recent advances in clearance monitoring of monoclonal antibodies in patients with inflammatory bowel diseases
Published in Expert Review of Clinical Pharmacology, 2021
Wannee Kantasiripitak, Zhigang Wang, Isabel Spriet, Marc Ferrante, Erwin Dreesen
Currently, clearance monitoring is performed during treatment with several small-molecule compounds, mainly to improve individual patients’ treatment efficacy and minimize the risk of toxicities [65,66]. More specifically, estimated clearance has been employed in several inpatient settings such as critically ill patients and oncology. In critically ill patients with sepsis or septic shock who received a continuous infusion of piperacillin-tazobactam, data supported the use of piperacillin clearance via a dosing software tool to ensure sufficient drug exposure throughout the entire treatment course [66]. Moreover, the clearance of piperacillin was found to be a predictor of hospital mortality. In patients with cancers who received high-dose methotrexate (i.e. more than 500 mg/m2), renal clearance of methotrexate has been closely monitored to prevent and mitigate significant acute kidney injury and other subsequent adverse events [65]. The renal clearance of methotrexate during each treatment cycle has been monitored by serum methotrexate concentrations combined with measurement of kidney function (via serum creatinine and urine outputs) [65]. However, in practice, the safety of high-dose methotrexate treatment can be monitored solely using kidney function markers.