PK/PD of High Dose Pip/Tazo in Obese Patients

Loma Linda University (LLU)

Status: Completed

Conditions: Obesity

Treatments: Drug: Piperacillin/Tazobactam Standard Dose to High Dose

Study type: Interventional

Funder types: Other

Identifiers

NCT01923363

5130259

Details and patient eligibility

About

Worldwide rates of obesity have doubled in the last 30 years, and obesity has been associated as a risk factor for hospital-acquired infections and increased occurrence of death in critically-ill patients. Piperacillin/tazobactam is a commonly prescribed antibiotic for critically ill patients with an infection, however, limited information exists for dosing this drug in obese patients. In these limited reports, standard doses of piperacillin/tazobactam given to the small number of obese patients resulted in lower blood concentrations, which could lead to inadequate killing of bacteria. The purpose of this study is to compare blood concentrations from standard piperacillin/tazobactam dosing compared to higher dosing regimens in obese patients. This study will also include information on the safety and tolerability of the higher dose regimens. The study investigators believe that the higher dosing regimen will produce adequate blood levels in obese patients and will not add any more risk of harm to obese patients receiving this higher dose.

Enrollment: 29 patients

Sex: All

Ages: 18 to 89 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• BMI greater than or equal to 30 kg/m2
• Weight at least 105 kg
• Age 18-89 years of age
• Prescribed piperacillin/tazobactam at standard doses for suspected or confirmed infection(s)
• English or Spanish speaking
• Central line access

Exclusion criteria

• Do not meet specified inclusion criteria
• Hepatic impairment classified by Child-Pugh Class B or greater
• Documented pre-existing seizure disorder
• Documented pre-existing hematologic disorder
• Pregnancy
• Documented allergy or contraindication to beta-lactams or tazobactam

Trial design

Primary purpose: Basic Science

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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29 participants in 1 patient group

Standard Dose to High Dose Piperacillin/Tazobactam

Experimental group

Description:

Patients will receive a standard dose of piperacillin/tazobactam, then will have subsequent pharmacokinetic analyses on the blood concentrations drawn while on standard dose. Then, they will be switched to higher dose, with subsequent pharmacokinetic analyses performed on those blood concentrations while on higher dose. These pharmacokinetics of each dosing regimen will be compared.

Treatment:

Drug: Piperacillin/Tazobactam Standard Dose to High Dose