Pharmacokinetic evaluation of piperacillin-tazobactam

Importance of the field: Piperacillin-tazobactam is a frequently prescribed intravenous antibiotic for moderate to severe infections used in hospital settings because of its broad activity against many pathogenic bacteria including Pseudomonas aeruginosa. However, its pharmacokinetics (PK) can be significantly altered in a variety of states. Areas covered in this review: This article provides a comprehensive and critical review of the PK of piperacillin-tazobactam in different patient populations. The pharmacodynamics (PD) of piperacillin-tazobactam is also discussed. What the reader will gain: The importance of appropriate antibiotic dosing in the context of the global tendency for reduced susceptibility of bacteria, including P. aeruginosa is emphasized. The interrelationship between PK and PD is discussed to provide an understanding of methods for procuring dosing regimens that increase the likelihood of clinical success for individual patients. Alternative dosing regimens, which may include administration by extended or continuous infusion of piperacillin-tazobactam as a mechanism to increase the likelihood of pharmacodynamic target attainment, are described. Take home message: Where piperacillin-tazobactam is required for treatment, applying knowledge of PK and PD characteristics can facilitate optimal outcomes.