Population pharmacokinetics and pharmacodynamics of piperacillin in critically ill patients during the early phase of sepsis

This study aimed to characterize the population pharmacokinetics (PKs) of piperacillin and investigate probability of target attainment (PTA) and cumulative fraction of response (CFR) of various dosage regimens in critically ill patients during the early phase of sepsis. Forty-eight patients treated with piperacillin/tazobactam were recruited. Five blood samples were drawn before and during 0 –0.5, 0.5–2, 2–4 and 4–6 or 8 h after administration. Population PKs was analyzed using NONMEM®. The PTA of 90%fT>MIC target and CFR were determined by Monte Carlo simulation. The two compartment model best described the data. Piperacillin clearance (CL) was 5.37 L/h, central volume of distribution (V1) was 9.35 L, and peripheral volume of distribution was 7.77 L. Creatinine clearance (CLCr) and mean arterial pressure had a significant effect on CL while adjusted body weight had a significant impact on V1. Subtherapeutic concentrations can occur during the early phase of sepsis in critically ill patients with normal renal function. The usual dosage regimen, 4  g of piperacillin infused over 0.5 h every 6 h, could not achieve the target for susceptible organisms with MIC 16 mg/L in patients with CLCr ≥ 60 mL/min. Our proposed regimen for the patients with CLCr 60-120  mL/min was an extended 2 h infusion of 4 g of piperacillin every 6 h. Most regimens provided CFR ≥ 90% for th...
Source: Journal of Pharmacokinetics and Pharmacodynamics - Category: Drugs & Pharmacology Source Type: research

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Publication date: Available online 9 December 2019Source: Journal of ColoproctologyAuthor(s): Seyedeh Elham Norollahi, Seyed Mohammad Taghi Hamidian, Zeynab Khazaee Kohpar, Rezvan Azadi, Pooya Rostami, Sogand Vahidi, Sahar Ghazanfari, Farnaz Azar Shabe, Roya Khaksar, Ali Akbar SamadaniAbstractColorectal cancer is one of the most important malignancies in the classification of gastrointestinal cancers. One of the predisposing factors at molecular level for this cancer is via WNT signaling which is associated with the vast numbers of different genes. Thus, in this study, we aimed to investigate whether Adenomatous Polyposis ...
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
We reported a general increase of unnecessary urine cultures in both community and hospital patients. The most representative microorganism isolated from Community (58.2%) and Hospital (47.6%) was E. coli. UTIs causative bacteria in hospitalized patients was more than twice as resistant to Trimetoprim/sulphamethoxazole (OR 2.26) and Imipenem (OR 2.56), for Gram-positive and Gram-negative, respectively, than in Community patients. Nitrofurantoin was the only agent without differences in resistance rate between community and hospital UTIs. Therefore, physicians could use it as a definitive therapy for uncomplicated cystitis ...
Source: New Microbiologica - Category: Microbiology Tags: New Microbiol Source Type: research
Authors: Rovida F, Nepita EV, Giardina F, Piralla A, Campanini G, Baldanti F Abstract About 15,000 hospitalizations due to group A Rotavirus gastroenteritis (RVA) are recorded each year in Italy. In the present study, we report the seasonal distribution and molecular characterization of RVA in pediatric and adult hospitalized patients in the period September 2015-April 2018 in Pavia province, Lombardy Region. During the study period, stool samples of 1450 patients with acute gastroenteritis were analyzed and 122 were RVA positive, the majority belonging to pediatric patients (94.0%) while only a minority of patient...
Source: New Microbiologica - Category: Microbiology Tags: New Microbiol Source Type: research
Authors: Kawanishi M, Hisatomi Y, Oda Y, Shimohara C, Tsunematsu Y, Sato M, Hirayama Y, Miyoshi N, Iwashita Y, Yoshikawa Y, Sugimura H, Mutoh M, Ishikawa H, Wakabayashi K, Yagi T, Watanabe K Abstract Colibactin is a polyketide-peptide genotoxin produced by enteric bacteria such as E. coli, and is considered to contribute to the development of colorectal cancer. We previously isolated E. coli strains from Japanese colorectal cancer patients, and in the present study we investigated the genotoxic potency of the colibactin-producing (clb+) E. coli strains that carry the polyketide synthases "pks" gene cluste...
Source: Journal of Toxicological Sciences - Category: Toxicology Tags: J Toxicol Sci Source Type: research
Publication date: Available online 10 December 2019Source: Progress in Biophysics and Molecular BiologyAuthor(s): Ambuj Kumar Kushwaha, Shashi BhushanAbstractProtein synthesis in all the living cells is mediated by a large protein-RNA complex called the ribosome. These macromolecular complexes can range from 2.5 (prokaryotes) to 4.2 MDa(eukaryotes) in size and undergo various conformational transitions during protein synthesis to translate the genetic code into the nascent polypeptide chains. Recent advances in cryo-electron microscopy (cryo-EM) and image processing methods have provided numerous detailed structures of rib...
Source: Progress in Biophysics and Molecular Biology - Category: Molecular Biology Source Type: research
(University of Maryland School of Medicine) Each year, millions of people contract serious diarrheal illnesses typically from contaminated food and water. Among the biggest causes of diarrheal diseases are the bacteria Shigella and enterotoxigenic Escherichia coli (ETEC), and researchers at the University of Maryland School of Medicine are testing a vaccine designed to offer protection against these serious pathogens.
Source: EurekAlert! - Infectious and Emerging Diseases - Category: Infectious Diseases Source Type: news
An oral, inactivated enterotoxigenic Escherichia coli (ETEC) vaccine (ETVAX) is safe and immunogenic in children, according to a new phase-1/2 trial.Reuters Health Information
Source: Medscape Allergy Headlines - Category: Allergy & Immunology Tags: Infectious Diseases News Source Type: news
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Source: Biochimica et Biophysica Acta (BBA) Biomembranes - Category: Biochemistry Source Type: research
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Source: Polymer - Category: Chemistry Source Type: research
ConclusionPatients with MC were more likely to have both hyperplastic polyp and LG adenoma. If confirmed, such findings could suggest the discontinuation of anthranoid laxative use particularly in the elderly.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
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