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Using higher doses to compensate for tubing residuals in extended-infusion piperacillin-tazobactam

Wendy J Lam1, Tanaya Bhowmick, Alan Gross

  • 1Rutgers University Ernest Mario School of Pharmacy, Piscataway, NJ, USA. Wendy.Jung@gmail.com

The Annals of Pharmacotherapy
|May 30, 2013
PubMed
Abstract

Insights

Drug losses from intravenous pump tubing residuals can be compensated by increasing infusion volumes or using higher doses of piperacillin-tazobactam (PT). Adjusting PT dosing ensures effective treatment despite residual medication in infusion lines.

Area of Science:

  • Pharmacology
  • Pharmaceutical Technology
  • Clinical Pharmacy

Background:

  • Intravenous (IV) infusion lines retain residual drug volumes after administration.
  • This residual volume can lead to sub-therapeutic dosing, particularly with extended-infusion regimens.
  • Optimizing drug delivery is crucial for maximizing therapeutic efficacy.

Purpose of the Study:

  • To mathematically assess drug losses in IV infusion lines.
  • To evaluate methods for compensating drug loss due to residual volumes in IV pump tubing.
  • To inform dosing strategies for extended-infusion piperacillin-tazobactam.

Main Methods:

  • A literature review was conducted using Ovid MEDLINE and reference citations.
  • Search terms included tubing residuals, residual volume, piperacillin-tazobactam, and infusion pumps.
  • Studies focusing on extended-infusion piperacillin-tazobactam implementation were included.

Main Results:

  • Two studies addressed tubing residuals, both recommending increased infusion volumes.
  • One study suggested reducing infusion line dead space with alternative pump systems.
  • Calculations indicated higher piperacillin-tazobactam doses can compensate for tubing residuals.

Conclusions:

  • Extended-infusion piperacillin-tazobactam aims to maximize pharmacodynamic target attainment.
  • Higher piperacillin-tazobactam doses are a viable strategy to offset drug loss in IV pump tubing.
  • This approach ensures adequate drug delivery despite residual volumes.

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