Kohama Hanako, Ide Takeshi, Ikawa Kazuro, Morikawa Norifumi, Nishi Shinichi
Division of Intensive Care Unit, Hyogo College of Medicine, Nishinomiya.
Department of Clinical Pharmacotherapy, Hiroshima University, Hiroshima, Japan.
Clin Pharmacol. 2017 Feb 24;9:39-44. doi: 10.2147/CPAA.S127502. eCollection 2017.
Tazobactam/piperacillin (TAZ/PIPC), which is often combined with continuous renal replacement therapy (CRRT), induces renal excretion and is thought to have a high component removal rate for blood purification. CRRT procedures vary depending on the country, region, and institution. It is not clear whether the dose of TAZ/PIPC for use in Japan can be determined based on studies conducted in other countries. Therefore, in this study, we examined the suitability of recommended dose in Japan.
The study subjects consisted of 10 patients who received TAZ/PIPC during CRRT in the intensive care unit of Hyogo College of Medicine, Nishinomiya, Japan. We used a one-compartment model to characterize and parameterize the pharmacokinetics of TAZ/PIPC because their blood levels were eliminated monoexponentially.
Compared with the data of healthy adults, the half-lives (t) of both PIPC and TAZ were prolonged while their clearance rates decreased.
For the continuous hemodiafiltration procedure adopted in Japan, we concluded that the dose and frequency were appropriate because the patients who received PIPC/TAZ 2.25 g twice a day during continuous hemodiafiltration maintained appropriate blood levels of both PIPC and TAZ.
他唑巴坦/哌拉西林（TAZ/PIPC）常与连续性肾脏替代治疗（CRRT）联合使用，可促进肾脏排泄，且被认为对血液净化具有较高的成分清除率。CRRT程序因国家、地区和机构而异。目前尚不清楚日本使用的TAZ/PIPC剂量是否可以根据其他国家进行的研究来确定。因此，在本研究中，我们检验了日本推荐剂量的适用性。
研究对象为日本西宫市兵库医科大学重症监护病房接受CRRT期间使用TAZ/PIPC的10例患者。由于TAZ/PIPC的血药浓度呈单指数消除，我们采用一室模型对其药代动力学进行表征和参数化。
与健康成年人的数据相比，PIPC和TAZ的半衰期（t）均延长，清除率降低。
对于日本采用的连续性血液透析滤过程序，我们得出结论，剂量和频率是合适的，因为在连续性血液透析滤过期间每天两次接受2.25 g PIPC/TAZ的患者维持了PIPC和TAZ的适当血药浓度。
