국내 3차 병원 비만 암환자에서 Piperacillin/Tazobactam의 용량 적절성 분석

Abstract

Abstract: Piperacillin/tazobactam (TZP) is one of antibiotics against a broad spectrum of gram-positive, gram-negative, and aerobic and anaerobic strains of bacteria. It is indicated to treat principally pneumonia, peritonitis, febrile neutropenia, intra-abdominal infection, or to use prophylatic treatment. Studies have shown that it can cause the high risk of serious nephrotoxicity in patients with CrCl<40mL/min. Additionally, due to leading to changes in its pharmacokinetic and pharmacodynamic parameters by TZP-treated patients' renal functions and obesity, it is important to administrate as well as to monitor TZP based on the consideration of their renal functions and Body Mass Index (BMI) levels in the process of TZP-treatment. However, studies related to these points, especially in cancer patients, have been rarely performed in Korea. The purposes of this study were to determine the appropriateness of initial administration dose of TZP and examine its dosing appropriateness based on renal functions of obese cancer patients in a tertiary hospital. This study was retrospectively conducted through Electronic Medical Record (EMR) which contained laboratory data and TZP dosing of each patient. Out of 7058 patients during the study period, 102 were selected based on inclusion and exclusion criteria and classified by their renal functions. As a result, although TZP should be used based on patients' renal functions to adjust its dose, its initial dose and dosing interval were consistently used without considering patients' renal functions on a regular basis. Especially, in the comparison with FDA dosing standard of TZP, approximately twice patients with 20mL/min≤CrCl≤40mL/min received domestically 4.5g instead of 2.25g as the TZP starting dose, which indicated that twice TZP doses were administered. Therefore, Further related studies are required to confirm the results from this study as well as to better optimize TZP dosing for more effective and safer TZP use in the infected patients treatment process, decreasing its adverse effects.