Usage and Dosing
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Renal Adjustment
| Half-life bình thường | Piperacillin: 1 Tazobactam: 1 |
|---|---|
| Half-life ESRD | Piperacillin: 3–5 Tazobactam: 2.8 |
| Liều bình thường | Extended Infusion: 4.5 gm IV (over 4 hr) q8h Intermittent Infusion: Nosocomial pneumonia: 4.5 gm IV (over 30 min) q6h All other indications: 3.375 gm IV (over 30 min) q6h |
| Chỉnh liều suy thận | Extended Infusion: CrCl ≥20: No dosage adjustment CrCl <20: 4.5 gm (over 4 hr) q12h Intermittent Infusion: Nosocomial pneumonia: CrCl >40: No dosage adjustment CrCl 20–40: 3.375 gm q6h CrCl <20: 2.25 gm q6h All other indications: CrCl >40: No dosage adjustment CrCl 20–40: 2.25 gm q6h CrCl <20: 2.25 gm q8h |
| Hemodialysis | Extended Infusion: 4.5 gm (over 4 hr) q12h Intermittent Infusion: Nosocomial pneumonia: 2.25 gm q8h (+0.75 gm AD on dialysis days) All other indications: 2.25 gm q12h (+0.75 gm AD on dialysis days) |
| CAPD | Extended Infusion: No data Intermittent Infusion: Nosocomial pneumonia: 2.25 gm q8h All other indications: 2.25 gm q12h |
| CRRT | Extended Infusion: 3.375–4.5 gm (over 4 hr) q8h Intermittent Infusion: 3.375–4.5 gm q6h42, 47 |
| SLED | Intermittent Infusion: 4.5 gm q8h May use extended infusion53 |
Hepatic Adjustment
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ECMO Dosing Adjustment
| Effect of ECMO | Minimal impact on drug PK |
|---|---|
| Dose recommendation | ECMO-specific dose adjustment not required |
| Comments, reference | Use non-ECMO ICU dosing strategies. Extended infusion (with therapeutic drug monitoring, if available) improves rate of target attainment. Ref: Clin Pharmacokinet 2026;65:193. |
Intraperitoneal Dosing Adjustment, CAPD
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Obesity Dosing Adjustment
| Recommendation | 4.5 gm IV (over 4 hr) q6-8h |
|---|---|
| Comments | Suggested dosing in obesity particularly for critically ill patients, if MICs ≥8 µg/mL, or CrCl >100 mL/min (Pharmacotherapy 2023;43:226). |
Adverse Effects
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Dược lý
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