The mean concentrations of piperacillin and tazobactam in plasma in equilibrium are presented in Tables 1-2. The maximum concentrations of piperacillin and tazobactam in plasma are reached immediately after completion of intravenous administration.
Table 1
Equilibrium plasma concentrations in adults after a five-minute intravenous injection of piperacillin / tazobactam
Concentrations of piperacillin in plasma (μg / ml)
The dose of piperacillin / tazobactam | 5** mines | 30 mines | 1 h | 2h | 3 hours | 4 h |
2g / 250mg | 237 | 76 | 38 | 13 | 6 | 3 |
4g / 500mg | 364 | 165 | 92 | 37 | 16 | 7 |
Concentrations of tazobactam in plasma (μg / ml) The dose of piperacillin / tazobactam | 5** mines | 30 mines | 1 h | 2 h | 3 hours | 4 h | 2g / 250mg | 23.4 | 8.0 | 4.5 | 1.7 | 0.9 | 0.7 | 4g / 500mg | 34.3 | 17.9 | 10.8 | 4.8 | 2.0 | 0.9 | |
Ending 5 minute introduction
Table 2
Equilibrium plasma concentrations in adults after a thirty-minute intravenous injection of piperacillin / tazobactam
Concentrations of piperacillin in plasma (μg / ml) The dose of piperacillin / tazobactam | 30** mines | 1 h | 1.5 h | 2 h | 3 hours | 4 h | 2g / 250mg | 134 | 57 | 29 | 17 | 5 | 2 | 4g / 500mg | 298 | 141 | 87 | 47 | 16 | 7 | |
Concentrations of tazobactam in plasma (μg / ml) The dose of piperacillin / tazobactam | 30** mines | 1 h | 1.5 h | 2h | 3 hours | 4h | 2g / 250mg | 14.8 | 7.2 | 4.2 | 2.6 | 1.1 | 0.7 | 4g / 500mg | 33.8 | 17.3 | 11.7 | 6.8 | 2.8 | 1.3 | |
Ending 30 minute introduction |
When the dose of the combination is increased piperacillin 2 g / tazobactam 250 mg to 4 g / 500 mg, respectively, a disproportionate increase (approximately 28%) of the concentration of piperacillin and tazobactam.
The binding to plasma proteins of both piperacillin and tazobactam is approximately 30%, while the presence of tazobactam does not affect this parameter of piperacillin, and the presence of piperacillin is tazobactam.
Piperacillin / tazobactam is widely distributed in tissues and body fluids, including in the intestinal mucosa, gall bladder, lungs, bile, female genitalia (uterus, ovaries and fallopian tubes) and bones. The average concentrations in tissues are from 50 to 100% of the concentration in the plasma.
Piperacillin is metabolized to a low-activity deshetylmetabolite; tazobactam - before the inactive metabolite. Piperacillin and tazobactam are excreted by the kidneys through glomerular filtration and tubular secretion. Piperacillin is rapidly excreted unchanged, 68% of the dose is detected in the urine. Tazobactam and its metabolite are rapidly excreted by renal excretion, 80% of the dose taken is unchanged, and the remaining amount is in the form of a metabolite. Piperacillin, tazobactam and desethylpiperacillin are also excreted with bile and excreted by the intestine.
The half-life of piperacillin and tazobactam from plasma is 0.7-1.2 hours. With a decrease in creatinine clearance, the half-life of piperacillin and tazobactam is prolonged.
Impaired renal function
As the creatinine clearance decreases, the half-lives of piperacillin and tazobactam increase. With a decrease in creatinine clearance below 20 ml / min, the half-lives of piperacillin and tazobactam, compared with patients with normal renal function, increase 2 and 4 times, respectively.
During hemodialysis, 30 to 50% of piperacillin and 5% of the dose of tazobactam in the form of a metabolite are excreted.When carrying out peritoneal dialysis, respectively, about 6 and 21% of piperacillin and tazobactam are excreted, with 18% of the tazobactam being excreted in the form of its metabolite.
Impaired liver function
Although in patients with impaired liver function, the half-lives of piperacillin and tazobactam increase, dose adjustment is not required.