title: Altered pharmacokinetics of piperacillin in febrile neutropenic patients with hematological malignancy.
abstract: This study assessed the pharmacokinetics and dosing adequacy of piperacillin in febrile neutropenic patients after the first dose. Pharmacokinetic analysis was performed using noncompartmental methods. We observed an elevated volume of distribution (29.7 ± 8.0 liters [mean ± standard deviation]) and clearance (20.2 ± 7.5 liters/h) compared to data from other patient populations. Antibiotic exposure did not consistently result in therapeutic targets. We conclude that alternative dosing strategies guided by therapeutic drug monitoring may be required to optimize exposure.
authors.affiliation: School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, Australia fekade.sime@mymail.unisa.edu.au.
authors.forename: Fekade Bruck
authors.initials: FB
authors.lastname: Sime
authors.affiliation: School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Roberts
authors.affiliation: SA Pathology and the University of Adelaide, Adelaide, Australia.
authors.forename: Morgyn S
authors.initials: MS
authors.lastname: Warner
authors.affiliation: Department of Haematology/Oncology, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Uwe
authors.initials: U
authors.lastname: Hahn
authors.affiliation: School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia Therapeutics Research Centre, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Robertson
authors.affiliation: Cancer Clinical Trials, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Yeend
authors.affiliation: Cancer Clinical Trials, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Andy
authors.initials: A
authors.lastname: Phay
authors.affiliation: Department of Haematology/Oncology, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Sheila
authors.initials: S
authors.lastname: Lehman
authors.affiliation: Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia Burns, Trauma, and Critical Care Research Centre, University of Queensland, Herston, Brisbane, Queensland, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lipman
authors.affiliation: Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Adelaide, Australia.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Peake
authors.affiliation: School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia Burns, Trauma, and Critical Care Research Centre, University of Queensland, Herston, Brisbane, Queensland, Australia.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Roberts
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D005334:Fever / Q000150:complications / Q000188:drug therapy*; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy*; D010878:Piperacillin / Q000008:administration & dosage / Q000493:pharmacokinetics*
chemical_list: D000900:Anti-Bacterial Agents; D010878:Piperacillin