PMID- 36830273 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230227 IS - 2079-6382 (Print) IS - 2079-6382 (Electronic) IS - 2079-6382 (Linking) VI - 12 IP - 2 DP - 2023 Feb 9 TI - Evaluation of Piperacillin/Sulbactam, Piperacillin/Tazobactam and Cefoperazone/Sulbactam Dosages in Gram-Negative Bacterial Bloodstream Infections by Monte Carlo Simulation. LID - 10.3390/antibiotics12020363 [doi] LID - 363 AB - The optimal regimens of piperacillin/sulbactam (PIS 2:1), piperacillin/tazobactam (PTZ 8:1), and cefoperazone/sulbactam (CSL 2:1) are not well defined in patients based on renal function. This study was conducted to identify optimal regimens of BLBLIs in these patients. The antimicrobial sensitivity test was performed by a two-fold agar dilution method. Monte Carlo simulation (MCS) was used to simulate the probability of target attainment (PTA) and the cumulative fraction of response (CFR) for various dosing regimens in patients with different renal functions. For strains with an MIC 90 mL/min. For patients with CrCL 60-90 mL/min, PIS 4.5 g q6h achieved 81.2% CFR; for those with CrCL 40-59 mL/min, PIS 4.5 g q8h achieved 80.25% CFR. However, for patients infected by ESBL-producing Enterobacteriaceae, PIS 4.5 g q6h achieved a CFR lower than 80%. For patients infected by A. baumannii with a CrCL of 31-60 mL/min, PIS 6.0 g q8h and 4.5 g q6h achieved 81.24% and 82.42% CFR, respectively. For those infected by P. aeruginosa, PIS 4.5 g q6h reached 90% CFR. PIS and PTZ achieved a similar CFR when piperacillin was at the same dose. The CFRs of CSL were much lower than those of the other two agents in Enterobacteriaceae and P. aeruginosa infections. The antibacterial spectrum of PIS is superior to that of PTZ and CSL. Higher dosages and dosing adjustment according to renal function should be considered to treat Gram-negative bacterial BSIs. FAU - Wang, Xueting AU - Wang X AD - State Key Laboratory of Infectious Disease Diagnosis and Treatment, National Clinical Medical Research Center for Infectious Diseases, Collaborative Innovation Center for Infectious Disease Diagnosis and Treatment, The First Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China. FAU - Xiong, Luying AU - Xiong L AD - State Key Laboratory of Infectious Disease Diagnosis and Treatment, National Clinical Medical Research Center for Infectious Diseases, Collaborative Innovation Center for Infectious Disease Diagnosis and Treatment, The First Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China. FAU - Yu, Wei AU - Yu W AUID- ORCID: 0000-0002-1174-596X AD - State Key Laboratory of Infectious Disease Diagnosis and Treatment, National Clinical Medical Research Center for Infectious Diseases, Collaborative Innovation Center for Infectious Disease Diagnosis and Treatment, The First Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China. FAU - Huang, Chen AU - Huang C AD - Department of Respiratory Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo 315000, China. FAU - Ji, Jinru AU - Ji J AD - State Key Laboratory of Infectious Disease Diagnosis and Treatment, National Clinical Medical Research Center for Infectious Diseases, Collaborative Innovation Center for Infectious Disease Diagnosis and Treatment, The First Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China. FAU - Ying, Chaoqun AU - Ying C AD - State Key Laboratory of Infectious Disease Diagnosis and Treatment, National Clinical Medical Research Center for Infectious Diseases, Collaborative Innovation Center for Infectious Disease Diagnosis and Treatment, The First Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China. FAU - Liu, Zhiying AU - Liu Z AD - State Key Laboratory of Infectious Disease Diagnosis and Treatment, National Clinical Medical Research Center for Infectious Diseases, Collaborative Innovation Center for Infectious Disease Diagnosis and Treatment, The First Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China. FAU - Chen, Yunbo AU - Chen Y AD - State Key Laboratory of Infectious Disease Diagnosis and Treatment, National Clinical Medical Research Center for Infectious Diseases, Collaborative Innovation Center for Infectious Disease Diagnosis and Treatment, The First Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China. FAU - Xiao, Yonghong AU - Xiao Y AUID- ORCID: 0000-0003-4845-5904 AD - State Key Laboratory of Infectious Disease Diagnosis and Treatment, National Clinical Medical Research Center for Infectious Diseases, Collaborative Innovation Center for Infectious Disease Diagnosis and Treatment, The First Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China. LA - eng GR - 2021C03068/the key research and development program of Zhejiang province/ PT - Journal Article DEP - 20230209 PL - Switzerland TA - Antibiotics (Basel) JT - Antibiotics (Basel, Switzerland) JID - 101637404 PMC - PMC9952708 OTO - NOTNLM OT - Monte Carlo simulation OT - bloodstream infections OT - cefoperazone/sulbactam OT - pharmacokinetics/pharmacodynamics OT - piperacillin/sulbactam OT - piperacillin/tazobactam COIS- The authors declare no conflict of interest. EDAT- 2023/02/26 06:00 MHDA- 2023/02/26 06:01 PMCR- 2023/02/09 CRDT- 2023/02/25 01:15 PHST- 2022/11/22 00:00 [received] PHST- 2023/01/07 00:00 [revised] PHST- 2023/02/01 00:00 [accepted] PHST- 2023/02/25 01:15 [entrez] PHST- 2023/02/26 06:00 [pubmed] PHST- 2023/02/26 06:01 [medline] PHST- 2023/02/09 00:00 [pmc-release] AID - antibiotics12020363 [pii] AID - antibiotics-12-00363 [pii] AID - 10.3390/antibiotics12020363 [doi] PST - epublish SO - Antibiotics (Basel). 2023 Feb 9;12(2):363. doi: 10.3390/antibiotics12020363.