128. Acute Kidney Injury in Patients on Concomitant Vancomycin and Piperacillin/Tazobactam: Are Extended Infusions to Blame? Bhagyashri Navalkele, MD; Shigehiko Karino, MD; Jason Pogue, PharmD; Nader Tashtoush, MD; Bakht Nishan, MD; Madiha Salim, MD; Shantanu Solanki, MD; Amina Pervaiz, MD; Hamadullah Shaikh, MD; Sunitha Koppula, MD; Keith Kaye, MD, MPH, FIDSA, FSHEA; Wayne State University, De...

Infectious complications related to prostate ultrasound and biopsy have increased in the past decade with the emergence of increasing fluoroquinolone bacterial resistance. We investigated the addition of intravenous (iv) piperacillin/tazobactam immediately prior to prostate ultrasound and biopsy with standard fluoroquinolone prophylaxis to determine if it would decrease the incidence of serious...

Acute kidney injury can result from a multitude of factors, including drug-induced causes. Medications like vancomycin and piperacillin/tazobactam have shown to be correlated with deterioration of the kidneys when used in excess or concomitantly with other potential offending agents [1,2]. While these agents have been both been associated with potential nephrotoxcity there is limited data on th...

The primary objectives of this analysis were to determine which pharmacokinetic model most accurately describes the elimination pathways for piperacillin in the presence of tazobactam through population pharmacokinetic modeling and to characterize its pharmacodynamic profile. Once the optimal pharmacokinetic model was identified, Monte Carlo simulation of 10,000 subjects with ADAPT II was perfo...

This survey was conducted to evaluate the in vitro activity of tigecycline against 50 isolates of multidrug-resistant (MDR) Acinetobacter baumannii. Isolates of A. baumannii were resistant to ciprofloxacin, chloramphenicol, imipenem, levofloxacin, piperacillin and piperacillin-tazobactam, but were always susceptible to colistin. MICs of tigecycline were determined by E-test in Mueller-Hinton ag...

BACKGROUND In 2005, pneumonia practice guidelines recommended broad-spectrum antibiotics for patients with risk factors for nosocomial pathogens. The impact of these recommendations on the ability of providers to match treatment with nosocomial pathogens is unknown. METHODS Among hospitalizations with a principal diagnosis of pneumonia at 128 Department of Veterans Affairs medical centers fro...

While extended infusions of piperacillin-tazobactam (TZP) are increasingly used in practice, the effect of infusion on the pharmacokinetic (PK) profile of TZP has not been widely assessed. To assess its effect on the pharmacokinetic profile of TZP, seven serum samples were collected from 11 hospitalized patients who received 3.375 g TZP intravenously for 4 h every 8 h. Population pharmacokineti...

The novel β-lactamase inhibitor avibactam is a potent inhibitor of class A, class C, and some class D enzymes. The in vitro antibacterial activity of the ceftazidime-avibactam combination was determined for a collection of Enterobacteriaceae clinical isolates; this collection was enriched for resistant strains, including strains with characterized serine β-lactamases. The inhibitor was added ei...

Previous studies have demonstrated that pharmaceutical equivalence and pharmacokinetic equivalence of generic antibiotics are necessary but not sufficient conditions to guarantee therapeutic equivalence (better called pharmacodynamic equivalence). In addition, there is scientific evidence suggesting a direct link between pharmacodynamic nonequivalence of generic vancomycin and promotion of resi...

OBJECTIVES Clostridium difficile infection (CDI) is a major cause of morbidity in the nosocomial environment. Antimicrobial agents such as the third-generation cephalosporins, lincosamides and aminopenicillins are well known for their propensity to induce CDI, but the definitive reasons why remain to be elucidated. Despite their broad spectrum of activity against both aerobic and anaerobic bact...