Piperacillin

Excreted Unchanged %
75-90
Half-Life (Normalesrd) Hours
0.8-1.5/3.3-5.1
Plasma Protein Binding %
30
Volume Of Distribution L/Kg
0.18-0.30
Dose For Normal Renal Function
3-4 g q6h
Adjustment For Renal Failure Method
I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
q6h[A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
q6-12h[A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
q12h[A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: 2 g q8h plus 1 g after HD
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [A]
References
Aronoff GR, Sloan RS, Brier ME, Luft FC. The effect of piperacillin dose on elimination kinetics in renal impairment. Eur J Clin Pharmacol. 1983; 24: 543-7. [PMID: 6222908] / Capellier G, Cornette C, Boillot A, Guinchard C, Jacques T, Blasco G, et al. Removal of piperacillin in critically ill patients undergoing continuous venovenous hemofiltration. Crit Care Med. 1998; 26: 88-91. [PMID: 9428548] / Francke EL, Appel GB, Neu HC. Pharmacokinetics of intravenous piperacillin in patients undergoing chronic hemodialysis. Antimicrob Agents Chemother. 1979; 16: 788-91. [PMID: 533260] / Keller E, B&#246; hler J, Busse-Grawitz A, Reetze-Bonorden P, Krumme B, Schollmeyer P. Single dose kinetics of piperacillin during continuous arteriovenous hemodialysis in intensive care patients. Clin Nephrol. 1995; 43 Suppl 1: S20-3. [PMID: 7781200] / Mueller SC, Majcher-Peszynska J, Hickstein H, Francke A, Pertschy A, Schulz M, et al. Pharmacokinetics of piperacillin-tazobactam in anuric intensive care patients during continuous venovenous hemodialysis. Antimicrob Agents Chemother. 2002; 46: 1557-60. [PMID: 11959598] / Valtonen M, Tiula E, Takkunen O, Backman JT, Neuvonen PJ. Elimination of the piperacillin/tazobactam combination during continuous venovenous haemofiltration and haemodiafiltration in patients with acute renal failure. J Antimicrob Chemother. 2001; 48: 881-5. [PMID: 11733473] / van der Werf TS, Mulder PO, Zijlstra JG, Uges DR, Stegeman CA. Pharmacokinetics of piperacillin and tazobactam in critically ill patients with renal failure, treated with continuous veno-venous hemofiltration (CVVH). Intensive Care Med. 1997; 23: 873-7. [PMID: 9310805]
Toxicity Notes
Sodium 1.9 mEq/g.