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PubMed1983

[Piperacillin concentration in the pelvic dead space exudate following surgery of cervical cancer].

Twelve patients with uterocervical cancer had panhysterectomy and were administered piperacillin (PIPC) at a dose of 2 g by one shot injection 2 times a day for a period of 5--6 days. PIPC concentrations in serum and pelvic dead space exudate were investigated before and after administration for 3 days (5 times). Serum concentration was observed ca. 49 micrograms/ml at 1 hour after the first, third and fifth administration. Concentrations in pelvic dead space exudate at 1 hour after the first, third and fifth administration were observed 26.7 +/- 5.8, 10.8 +/- 4.0 and 8.7 +/- 3.5 micrograms/ml, respectively. The highest concentration was 63.0 micrograms/ml at 1 hour after the first administration in case 4. It was thought that these concentrations were sufficient for the therapy of parametritis. No side effects caused by the drug were observed.

Aged↗
PubMed1984

[Concentration of piperacillin in bone].

Eighteen patients received 2.0 grams of piperacillin sodium (PIPC) intravenously. The concentrations of PIPC in serum, cancellous bone, and cortical bone were measured approximately 30 minutes after injection. Serum concentrations ranged from 9.10 to 167.0 micrograms/ml (mean 95.61 +/- 10.03 micrograms/ml). Cortical bone concentrations varied between 0 and 17.5 micrograms/g (mean 4.58 +/- 1.03 micrograms/g). The levels measured in cancellous bone ranged from 0.62-13.1 micrograms/g (mean 8.07 +/- 1.43 micrograms/g). PIPC achieved high concentrations in bone.

Aged↗
PubMed1995

Single dose kinetics of piperacillin during continuous arteriovenous hemodialysis in intensive care patients.

Piperacillin (Pi) kinetics in patients with acute renal failure treated by continuous arteriovenous hemodialysis (CAVHD) are not known. Therefore, dosing regimens have been based on kinetic data derived from patients with chronic renal failure and principal pharmacokinetic considerations [Reetze-Bonorden et al. 1993]. From these estimations it has been predicted that approximately 30% of the dose of Pi is removed by CAVHD (dialysate/ultrafiltrate (D/UF) flow rate 1.5 liter/hour). To confirm this estimate single dose (4g i.v.) Pi kinetics were studied in 12 intensive care patients with anuric acute renal failure due to septicemia treated by CAVHD. Pi plasma and D/UF levels were measured by HPLC. Sieving/Saturation of Pi in the D/UF was 0.71 +/- 0.21 (+/- SD). With a mean D/UF flow rate of 20.4 +/- 1.5 ml/min, the mean extracorporal clearance (Clextra) was 12.2 +/- 1.0 ml/min and accounted for 29% (range 14-48%) of total body clearance (ClB = 47.1 +/- 22.3 ml/min). In 7 out of 12 patients the fraction of the dose eliminated by CAVHD reached a significant value above 25%. The mean volume of distribution (Vd) and elimination half life (t1/2) were 25.8 +/- 3.8 liter and 7.4 +/- 2.9 hours, respectively. In conclusion the extent of extracorporal elimination of Pi by CAVHD was well in agreement with the estimation previously published. In intensive care patients with acute renal failure on continuous hemodialysis Pi dosing should take into account the possibly significant elimination of Pi. The usual dose for anuric patients may be increased by 50% to avoid underdosing in these critically ill patients.

Acute Kidney Injury↗
PubMed1995

[A comparative study of tazobactam/piperacillin and piperacillin in bacterial pneumonia].

The efficacy, safety and usefulness of tazobactam/piperacillin (TAZ/PIPC), in bacterial pneumonia and lung abscess were determined with PIPC as the control in a multi-institutional comparative study a penicillin antibiotic for injection prepared by combining a newly developed beta-lactamase inhibitor, tazobactam (TAZ), with a broad spectrum penicillin antibiotic, piperacillin (PIPC), at a ratio of 1:4. TAZ/PIPC was intravenously injected at a dose of 2.5 g (titer) twice a day, and PIPC at a dose of 2.0 g (titer) twice a day as a rule for 14 days. The following results were obtained: 1. The efficacy rates for bacterial pneumonia and lung abscess were 94% (80/85) in TAZ/PIPC group and 89% (70/79) in PIPC group, showing no significant difference between the two groups. 2. In a comparison of degrees of improvement in clinical symptoms, signs and laboratory findings, there were no significant differences between the two groups except for results on thoracic rales after three days of administration. 3. As for bacteriological effects, the elimination rates of causative organisms were 98% (40/41) in the TAZ/PIPC group and 80% (28/35) in the PIPC group. Thus, the TAZ/PIPC group was significantly superior to the PIPC group. The TAZ/PIPC group showed significantly better eradication of bacteria as well. Bacteria considered to be pyogenic were detected in 80 patients (43 administered TAZ/PIPC and 37 administered PIPC), but beta-lactamase production was confirmed in only 11 patients of each group. There were no significant differences in bacteriological effects among these patients. Minimum inhibitory concentrations of TAZ/PIPC against beta-lactamase producing organisms were distinctly superior to those of PIPC. 4. Side effects occurred in 10% (10/96) of the TAZ/PIPC group and 7% (7/95) of the PIPC group. Abnormal clinical laboratory test values were observed in 22% (20/92) of the TAZ/PIPC group and 18% (17/93) of the PIPC group. Thus, there were no significant differences between the two administration groups. 5. The usefulness rate in the TAZ/PIPC group was 87% (75/86) and it was 85% (67/79) in the PIPC group, showing no significant difference between them. The results suggest that TAZ/PIPC administered at a dose of 2.5 g (titer) twice a day is more useful than PIPC administered at a dose of 2.0 g (titer) twice a day in the treatment of bacterial pneumonia.

Adult↗
PubMed1995

[A comparative study of tazobactam/piperacillin and piperacillin in chronic respiratory tract infections].

The efficacy, safety and usefulness were evaluated for a combined antibiotic tazobactam/piperacillin (TAZ/PIPC) consisting of a new beta-lactamase inhibitor, tazobactam (TAZ), and a broad spectrum penicillin antibiotic, piperacillin (PIPC), in chronic respiratory tract infections with PIPC as the control in a multi-institutional comparative study. The drugs used were a preparation containing 0.5 g of TAZ and 2.0 g of PIPC per vial (TAZ/PIPC group) and a preparation containing 2.0 g of (PIPC group). The drugs were intravenously injected one vial at a time twice a day for 14 days as a rule. The following results were obtained: 1. Clinical effect There was no significant difference between TAZ/PIPC (86% or 76/88) and PIPC (81% or 69/85). 2. Bacteriological effect There was no significant difference between TAZ/PIPC (93% or 42/45) and PIPC (88% or 36/41) in terms of bacterial eradication rates. In 34 patients with beta-lactamase-producing pyogenic bacteria, there was no significant difference between TAZ/PIPC (77% or 10/13) and PIPC (88% or 15/17). 3. Degrees of improvement in clinical symptoms, signs and laboratory findings The TAZ/PIPC group was likely to show reductions in fever and the amount of sputum soon after administration. 4. Side effects Incidences of side effects were 7% (7/96) in the TAZ/PIPC group and 3% (3/89) in the PIPC group, showing no significant difference between the two groups. The main symptoms were allergic reaction and gastrointestinal symptoms. 5. Abnormal clinical laboratory test values The incidence was 17% (15/89) in the TAZ/PIPC group and 21% (18/87) in the PIPC group. The main symptoms were eosinophilia and hepatic dysfunction, and most of these symptoms were mild. 6. Usefulness The usefulness rates in the TAZ/PIPC group were 80% (71/89) and 78% (66/85) in the PIPC group, showing no significant difference. Thus, TAZ/PIPC exhibited excellent clinical effects and presented no troubles with safety. When comprehensively evaluated, TAZ/PIPC appears to be a very useful drug for the treatment of chronic respiratory tract infections.

Adult↗
PubMed1995

[Antimicrobial activities of piperacillin against fresh clinically isolated strains].

In order to evaluate the antimicrobial activity of piperacillin (PIPC), along with control agents, minimum inhibitory concentrations (MIC's) were determined against fresh clinically isolated strains from January to June, 1994. 1. The MIC70's of PIPC against major strains were approximately equal to those reported in the mid 1980s. 2. Strains for the study were supplied in approximately equal numbers from community-acquired hospitals and general hospitals. The ratios of bacteria resistant to beta-lactams including PIPC were low in the former group and high in the latter. 3. "New types of beta-lactam-resistant strains" which did not exist in mid 1980s but found at this time included benzylpenicillin (PCG)-insensitive Streptococcus pneumoniae, PCG-resistant S. pneumoniae, cephems-resistant Escherichia coli and beta-lactamase producing Prevotella spp. These bacteria were also found among strains obtained from community-acquired hospitals.

Bacteria↗
PubMedDate not supplied

[Piperacillin in the treatment of suppurative inflammatory complications in cancer patients].

Piperacillin (Pipril, Lederle, USA) is semisynthetic penicillin highly active against aerobic and anaerobic organisms. Its high activity was demonstrated with respect to 289 strains of aerobes, 82.7 per cent of the Pseudomonas aeruginosa strains being susceptible to Pipril. Diverse purulent inflammatory complications were treated with Pipril in doses of 8 to 24 g a day in 27 patients with malignant tumors. The clinical effect in 84.6 per cent of the cases was recorded. Complete elimination of the pathogens was observed in 73.5 per cent of the patients. Therefore, Pipril should be considered as one of the most active antibiotics for the treatment of purulent inflammatory complications in oncological patients.

Adolescent↗
PubMed1993

[A case of piperacillin-induced pneumonitis].

A 43-year-old woman was treated with piperacillin (PIPC) for spiking fever. Although she was afebrile, fever recurred on the 18th day of PIPC administration with progressive dyspnea and diffuse ground glass shadows on the chest X-ray. Bronchoalveolar lavage fluid (BALF) showed marked increase of total cell number and percentage of lymphocytes and a reduction of the ratio of CD4/CD8. Transbronchial lung biopsy (TBLB) specimen revealed interstitial infiltration of lymphocytes and histiocytes with granulomatous lesions. The drug lymphocyte stimulation test (DLST) was positive for PIPC. Based on these findings, the diagnosis of PIPC-induced pneumonitis was made. Recently, the incidence of drug-induced pneumonitis has increased, but to our knowledge this is a rare case report of PIPC-induced pneumonitis.

Adult↗
PubMedDate not supplied

[Piperacillin in prevention and therapy in gynecological surgery].

The authors have studied the use of sodic piperacillin in surgical gynecological prophylaxis. The drug, used in the intravenous tract, has proved efficacious for broad spectrum of antibacterial action versus gram+, gram-, and anaerobic and aerobic. It has shown an excellent tolerability by reducing hospital surgical infections (11% of cases) and sepsis (9.2% of cases) with social, economic and professional advantages.

Antibiotic Prophylaxis↗
PubMed1996

Perioperative pharmacokinetics of piperacillin during liver transplantation.

There have been few evaluations of the perioperative pharmacokinetics of antibiotics. Piperacillin (PPR) is a widely prescribed ureidopenicillin of established efficacy against enterobacteria and P. aeruginosa. The serum pharmacokinetics and perioperative safety of PPR were evaluated in 8 patients hospitalized for an orthotopic liver transplantation. The subjects were given a 60 mg/kg infusion of PPR once every 8 hours. PPR was assayed by HPLC and data were analyzed by a noncompartmental method. There were no adverse events during surgery. It seems that kinetics of PPR showed no variation during the anhepatic period. However, transplants notably modified the kinetics of PPR in comparison with data previously published in healthy volunteers. Trends were as follows: flattening of Cmax and prolongation of T1/2 (2.2 h vs 0.92 h). This phenomenon seems to be due to a marked increase in V(area) (44.0 1 vs 16.2 1) while C1 were similar. The increase in V(area) is probably the combined results of multiple factors including blood loss, vascular filling, combined prescription of vasoactive drugs, and, obviously, the surgical procedure itself. Concentrations of PPR were after 4 hours below (i.e. 5/8 patients) the MIC of P. aeruginosa (i.e. < or = 16 micrograms/ml). From 6 hours onwards antibacterial cover was insufficient against the majority of enterobacteria (i.e. < or = 8 micrograms/ml). This inadequate protection included the critical anhepatic period. Measured concentrations achieved by the initial dosage regimen were compared to those obtained by simulation using modified dosing pattern in order to ensure circulating levels constantly of 16 micrograms/ml or more. This leads to a suggested modified dosage pattern in which PPR would be given as 1 dose of 60 mg/kg every 4 hours. Under these conditions the expected concentrations should be constantly over 16 micrograms/ml and any risk of systemic accumulation is excluded.

Adult↗
PubMed1998

[A three-dimensional model for in vitro study of the association of three antibiotics. Application to the activity of piperacillin, tazobactam and amikacin against five strains of enterobacteria as a function of their phenotype of beta-lactam resistance].

We described an in vitro 3-dimensional model to study the bactericidal activity of piperacillin (P), tazobactam (T) and amikacin (A) in combination against 5 strains of enterobacteria with different resistance patterns of beta-lactam antibiotics. A synergy was defined by calculation of sigma FBCP,T,A = BCp/MBCp + BCT/MBCT + BCA/MBCA and classic sigma FBCs for each double combination. The therapeutic value of each antibiotic was estimated by comparison of its bactericidal concentrations alone and in double or triple combination.

Amikacin↗
PubMed1979

Pharmacokinetics of intravenous piperacillin in patients undergoing chronic hemodialysis.

The pharmacokinetic properties of piperacillin, a piperazine derivative of ampicillin, were determined in seven patients with creatinine clearances less than 7 ml/min who were undergoing chronic, intermittent hemodialysis. A two-compartment linear model was used to analyze the data. Mean elimination half-life was 1.26 +/- 0.1 h; the mean elimination constant was 0.95 +/- 0.08 h-1; the mean volume of distribution was 0.16 +/- 0.02 liters/kg of body weight; the mean volume of the central compartment was 0.10 +/- 0.01 liters/kg of body weight; and the mean clearance was 0.09 +/- 0.01 liters/h per kg of body weight. Mean elimination half-life while off dialysis of 2.1 h.

Adult↗
PubMed2004

Activity of levofloxacin and ciprofloxacin in combination with cefepime, ceftazidime, imipenem, piperacillin-tazobactam and amikacin against different Pseudomonas aeruginosa phenotypes and Acinetobacter spp.

BACKGROUND: Combination therapy is used to widen the antimicrobial spectrum, minimize toxicity and prevent the emergence of resistant mutants. METHODS: Synergy between levofloxacin or ciprofloxacin and ceftazidime, cefepime, imipenem, piperacillin-tazobactam and amikacin was evaluated by checkerboard assay with 55 strains and by time-kill curves with 8 strains of Pseudomonas aeruginosa and Acinetobacter spp. RESULTS: In the checkerboard assay, synergy and additivity were the most frequent effects observed among all the combinations against P. aeruginosa and Acinetobacter spp., with no significant differences between the two fluoroquinolones. No antagonism was observed. In the time-kill curves, synergy was evidenced against all the tested strains, at least for one combination at one of the time points considered. Levofloxacin and ciprofloxacin combined with ceftazidime, as well as levofloxacin plus amikacin, were synergistic for all the strains tested. CONCLUSION: Combinations of fluoroquinolones with beta-lactams or amikacin show an enhanced activity against P. aeruginosa and Acinetobacter spp.

Acinetobacter↗
PubMed1987

Antimicrobial susceptibility of bacteria isolated in 1985--with special reference to prevalence of methicillin-resistant staphylococcus aureus and activities of cefazolin, cefotaxime and piperacillin.

Antimicrobial susceptibility of nine species and one group of bacteria isolated from patients at the hospitals of Seoul National University, Severance, Hanyang University, and Kyungpuk University were tested by agar dilution method. S. aureus was most susceptible to cefazolin, methicillin and cotrimoxazole, and enterococci to ampicillin. Isolates of Enterobacteriaceae were most frequently susceptible to aminoglycosides and cefotaxime. Cefazolin susceptibility was markedly different from species to species. Aminoglycosides and piperacillin were more active than others against P. aeruginosa, and amikachin against A. anitratus. A large proportion of strains of several different species were conditionally susceptible to either tetracycline, ampicillin, cefazolin or cotrimoxazole suggesting the usefulness of these drugs for treatment of urinary tract infection. Activity of cefotaxime was highest against E. coli, and K. pneumoniae, while lowest against A. anitratus and P. aeruginosa. Decrease in the proportion of susceptible isolate was noted in E. coli and K. pneumoniae to cefazolin, K. pneumoniae, E. cloacae and S. marcescens to cotrimoxazole, and P. aeruginosa to tobramycin and gentamicin.

Anti-Bacterial Agents↗
PubMed1979

[A case of Leptospira hebdomadis infection treated with piperacillin (author's transl)].

A 35-year-old male went fishing at the Agano River side in the suburbs of Toyosaka City, in August 1977. He was admitted to the hospital then with the chief complaints of high fever and severe headache on the 5th day of illness. Following the intravenous drip infusion of 12 g piperacillin for 6 1/2 days, he became afebrile within 2 days and recovered rapidly. Bacteriological examination disclosed none of significant data. Serum agglutinin reaction for leptospirosis, however, was positive in a titer up to 1:2,560 to L. hebdomadis, except for L. icterohemorrhagiae, L. autumnalis, L. australis and L. canicola.

Adult↗