Studies on the pharmacokinetics of piperacillin/tazobactam in renal replacement therapy in patients with chronic renal failure

Purpose: To study the pharmacokinetics of piperacillin/tazobactam in renal replacement therapy (CRRT) in patients with chronic renal failure (CRF). Methods: Six CRF patients treated with CRRT in the First Affiliated Hospital of Hebei North University from April 2020 to July 2020 were selected and administered 4 g of piperacillin and 0.5 g of tazobactam within 30 min after, and at 5, 30, 45, 60, 90, 120, 180, 240, 360 and 480 min after CRRT. The DAS software was used to calculate pharmacokinetic parameters while linear regression was used to analyze the relationship among patient characteristics, CRRT parameters, and pharmacokinetics. Results: The Cmax of piperacillin and tazobactam was 118.46 (96.12 - 161.12) mg/L and 27.45 (14.75 - 28.45) mg/L, while the volume of distribution (Vd) was 1.16 (0.72 - 1.59) L/h and 0.72 (0.57 -0.82) L/kg, respectively. The value for elimination half-life (t1/2) was 4.66 (3.19 -8.45) h and 4.25 (3.42 - 5.96) h, while total clearance (CL) was 7.28 (5.58 - 9.73) L/h and 6.37 (4.28 - 10.04) L/h, respectively. Multivariate linear regression showed that piperacillin Cmax was negatively correlated with the flow velocity of the substitution fluid (β = -0.679, 95 % CI = -0.278 - 0.943, p < 0.001). Piperacillin CL was positively correlated with the flow velocity of the waste liquid (β = 0.956, 95 % CI = 1.267 - 4.796, p < 0.001). Conclusion: When used in CRF patients receiving CRRT, piperacillin and tazobactam show decrease in Cmax and CL, but increase in t1/2. This finding should provide useful guidance for clinicians concerned.