Piperacillin pharmacokinetics in pediatric patients

Abstract

The pharmacokinetics of piperacillin were studied in 15 pediatric patients (age range, 3.3 to 14.3 years). Piperacillin was administered in a dosage of 1.5 ± 0.4 g/m2 (mean ± standard deviation) every 4 to 6 h. Peak serum concentrations ranged from 69 to 354 μg/ml. The mean elimination half-life was 37.0 ± 13.3 min, which is shorter than that observed in most adults with normal renal function. The mean elimination half-life in three patients with renal impairment was 60.1 ± 12.4 min, and the mean ratio of renal clearance to total clearance was 0.57. These results suggest a significant nonrenal elimination of piperacillin. Based on these data, a dosage of 1.5 g/m2 given as a 30-min infusion every 4 h is suggested for children with normal renal function. For patients with renal impairment, the daily dosage could be calculated as follows: corrected dose = normal dose x (0.35 + [0.65 x {Cl(Cr)/0.06}]), where Cl(Cr) is the creatinine clearance expressed as liters per minute per square meter.