{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T22:06:50Z","timestamp":1763762810322,"version":"3.45.0"},"reference-count":27,"publisher":"The Pediatric Pharmacy Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>\n                    Continuous kidney replacement therapy (CKRT) can influence pharmacokinetics (PK), including clearance (CL) of antibiotics like piperacillin (PIP). Both CKRT intensity, or \u201cdialysis dose,\u201d and residual kidney function can alter PIP PK and pharmacodynamic (PD) target attainment (TA), defined by the percentage of time free PIP concentrations exceed the minimum inhibitory concentration (%\n                    <jats:italic>f<\/jats:italic>\n                    T &gt; MIC). In existing reports, children receiving PIP and CKRT are usually oligoanuric, so PIP PK\/PD in non-oligoanuric patients receiving high-intensity CKRT is unknown. This report analyzes free PIP PK\/PD in a child with robust kidney function who received 30-minute infusions of 100 mg\/kg PIP-tazobactam every 6 hours while on high-intensity CKRT after liver-kidney transplant for primary hyperoxaluria. Model-informed PK software was used to estimate PK\/PD parameters for periods on and off CKRT. PIP CL on CKRT was 66% higher than off CKRT (5.59 L\/hr vs 3.36 L\/hr). Nearly 100%\n                    <jats:italic>f<\/jats:italic>\n                    T &gt; 1xMIC (using 8 mg\/L for Enterobacterales) was achieved whether on or off CKRT, but only 60%\n                    <jats:italic>f<\/jats:italic>\n                    T &gt; 4xMIC was achieved on CKRT. CKRT CL was 40% of total CL on CKRT and 51% of the CKRT dialysis dose, suggesting PIP elimination was mostly renal despite high-intensity dialysis. Monitoring of free PIP concentrations may help ensure proper TA in non-oligoanuric patients receiving high-dose CKRT.\n                  <\/jats:p>","DOI":"10.5863\/jppt-24-00106","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T22:03:28Z","timestamp":1763762608000},"page":"673-679","source":"Crossref","is-referenced-by-count":0,"title":["Piperacillin Pharmacokinetics in a Pediatric Patient With Primary Hyperoxaluria Receiving High-Dose Continuous Dialysis Post Liver-Kidney Transplant"],"prefix":"10.5863","volume":"30","author":[{"given":"Mia","family":"Hagenauer","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine (MH, STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Translational and Clinical Pharmacology (MH, K. Pavia, K. Paice, STG, HRH), Cincinnati Children\u2019s Hospital Medical Center, Division of Critical Care Medicine (K. Pavia, K. Paice), Cincinnati Children\u2019s Hospital Medical Center, Center for Acute Care Nephrology (STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Nephrology and Hypertension (HRH), Cincinnati Children\u2019s Hospital Medical Center..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Pavia","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine (MH, STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Translational and Clinical Pharmacology (MH, K. Pavia, K. Paice, STG, HRH), Cincinnati Children\u2019s Hospital Medical Center, Division of Critical Care Medicine (K. Pavia, K. Paice), Cincinnati Children\u2019s Hospital Medical Center, Center for Acute Care Nephrology (STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Nephrology and Hypertension (HRH), Cincinnati Children\u2019s Hospital Medical Center..."},{"name":"Division of Critical Care Medicine (K. Pavia), Children\u2019s Mercy Hospital of Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelli","family":"Paice","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine (MH, STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Translational and Clinical Pharmacology (MH, K. Pavia, K. Paice, STG, HRH), Cincinnati Children\u2019s Hospital Medical Center, Division of Critical Care Medicine (K. Pavia, K. Paice), Cincinnati Children\u2019s Hospital Medical Center, Center for Acute Care Nephrology (STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Nephrology and Hypertension (HRH), Cincinnati Children\u2019s Hospital Medical Center..."},{"name":"Division of Critical Care Medicine (K. Paice), Penn State Health Children\u2019s Hospital, Hershey, PA"},{"name":"Department of Pediatrics (K. Paice), Penn State College of Medicine, Hershey, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonya Tang","family":"Girdwood","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine (MH, STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Translational and Clinical Pharmacology (MH, K. Pavia, K. Paice, STG, HRH), Cincinnati Children\u2019s Hospital Medical Center, Division of Critical Care Medicine (K. Pavia, K. Paice), Cincinnati Children\u2019s Hospital Medical Center, Center for Acute Care Nephrology (STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Nephrology and Hypertension (HRH), Cincinnati Children\u2019s Hospital Medical Center..."},{"name":"Department of Pediatrics (STG), University of Cincinnati College of Medicine, Cincinnati, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Rhodes","family":"Hambrick","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine (MH, STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Translational and Clinical Pharmacology (MH, K. Pavia, K. Paice, STG, HRH), Cincinnati Children\u2019s Hospital Medical Center, Division of Critical Care Medicine (K. Pavia, K. Paice), Cincinnati Children\u2019s Hospital Medical Center, Center for Acute Care Nephrology (STG), Cincinnati Children\u2019s Hospital Medical Center, Division of Nephrology and Hypertension (HRH), Cincinnati Children\u2019s Hospital Medical Center..."},{"name":"Division of Nephrology (HRH), Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, IL"},{"name":"Department of Pediatrics (HRH), Northwestern University Feinberg School of Medicine, Chicago, IL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"2","key":"i2331-348X-30-5-673-b01","series-title":"Clin J Am Soc Nephrol","first-page":"256","article-title":"Continuous KRT: a contemporary review","volume":"18","author":"Teixeira","year":"2023","unstructured":"Teixeira JP, Neyra JA, Tolwani A. Continuous KRT: a contemporary review. Clin J Am Soc Nephrol. 2023;18(2):256\u2013269."},{"issue":"2","key":"i2331-348X-30-5-673-b02","series-title":"J Transl Int Med","first-page":"62","article-title":"What a clinician should know about a renal replacement membrane?","volume":"6","author":"Honore","year":"2018","unstructured":"Honore PM, Spapen HD. What a clinician should know about a renal replacement membrane? J Transl Int Med. 2018;6(2):62\u201365."},{"issue":"19","key":"i2331-348X-30-5-673-b03","series-title":"Int J Mol Sci","first-page":"10238","article-title":"Renal replacement techniques in septic shock","volume":"22","author":"Hellman","year":"2021","unstructured":"Hellman T, Uusalo P, J\u00e4rvisalo MJ. Renal replacement techniques in septic shock. Int J Mol Sci. 2021;22(19):10238."},{"key":"i2331-348X-30-5-673-b04","series-title":"Front Pediatr","first-page":"1","article-title":"Antimicrobial dosing recommendations in pediatric continuous renal replacement therapy: a critical appraisal of current evidence","volume":"10","author":"Stitt","year":"2022","unstructured":"Stitt G, Dubinsky S, Edginton A, et al. Antimicrobial dosing recommendations in pediatric continuous renal replacement therapy: a critical appraisal of current evidence. Front Pediatr. 2022;10:1\u20138."},{"issue":"5","key":"i2331-348X-30-5-673-b05","series-title":"Ann Pharmacother","first-page":"501","article-title":"Piperacillin\/tazobactam: a new beta-lactam beta-lactamase inhibitor combination","volume":"29","author":"Schoonover","year":"1995","unstructured":"Schoonover LL, Occhipinti DJ, Rodvold KA, Danziger LH. Piperacillin\/tazobactam: a new beta-lactam beta-lactamase inhibitor combination. Ann Pharmacother. 1995;29(5):501\u2013514."},{"key":"i2331-348X-30-5-673-b06","year":"2012","unstructured":"ZOSYN (piperacillin and tazobactam for injection, USP) [product information]. Philadelphia, PA: Pfizer; 2012. Accessed September 5, 2025. https:\/\/labeling.pfizer.com\/ShowLabeling.aspx?id=502"},{"issue":"6","key":"i2331-348X-30-5-673-b07","series-title":"Intensive Care Med","first-page":"1127","article-title":"Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper","volume":"46","author":"Abdul-Aziz","year":"2020","unstructured":"Abdul-Aziz MH, Alffenaar JWC, Bassetti M, et al. Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper. Intensive Care Med. 2020;46(6):1127\u20131153."},{"issue":"7","key":"i2331-348X-30-5-673-b08","series-title":"Expert Rev Anti Infect Ther","first-page":"677","article-title":"Optimizing \u03b2-lactams treatment in critically-ill patients using pharmacokinetics\/pharmacodynamics targets: are first conventional doses effective?","volume":"15","author":"Delattre","year":"2017","unstructured":"Delattre IK, Taccone FS, Jacobs F, et al. Optimizing \u03b2-lactams treatment in critically-ill patients using pharmacokinetics\/pharmacodynamics targets: are first conventional doses effective? Expert Rev Anti Infect Ther. 2017;15(7):677\u2013688."},{"issue":"8","key":"i2331-348X-30-5-673-b09","series-title":"J Clin Pharm Ther","first-page":"1091","article-title":"Pharmacokinetics of piperacillin and tazobactam in critically Ill patients treated with continuous kidney replacement therapy: a mini-review and population pharmacokinetic analysis","volume":"47","author":"Selig","year":"2022","unstructured":"Selig DJ, DeLuca JP, Chung KK, et al. Pharmacokinetics of piperacillin and tazobactam in critically Ill patients treated with continuous kidney replacement therapy: a mini-review and population pharmacokinetic analysis. J Clin Pharm Ther. 2022;47(8):1091\u20131102."},{"issue":"12","key":"i2331-348X-30-5-673-b10","series-title":"Antimicrob Agents Chemother","first-page":"e0113522","article-title":"Piperacillin population pharmacokinetics and dosing regimen optimization in critically ill children receiving continuous renal replacement therapy","volume":"66","author":"Thy","year":"2022","unstructured":"Thy M, Urien S, Foissac F, et al. Piperacillin population pharmacokinetics and dosing regimen optimization in critically ill children receiving continuous renal replacement therapy. Antimicrob Agents Chemother. 2022;66(12):e0113522."},{"issue":"9","key":"i2331-348X-30-5-673-b11","series-title":"Clin Microbiol Infect","first-page":"1287.e9","article-title":"Population pharmacokinetics of piperacillin in critically ill children including those undergoing continuous kidney replacement therapy","volume":"28","author":"Butrague\u00f1o-Laiseca","year":"2022","unstructured":"Butrague\u00f1o-Laiseca L, Marco-Ari\u00f1o N, Troconiz IF, et al. Population pharmacokinetics of piperacillin in critically ill children including those undergoing continuous kidney replacement therapy. Clin Microbiol Infect. 2022;28(9):1287.e9\u20131287.e15."},{"issue":"10","key":"i2331-348X-30-5-673-b12","series-title":"Pharmacotherapy","first-page":"1061","article-title":"Molecular adsorbent recirculating system therapy with continuous renal replacement therapy enhanced clearance of piperacillin in a pediatric patient and led to failure to attain pharmacodynamic targets","volume":"40","author":"Tang Girdwood","year":"2020","unstructured":"Tang Girdwood S, Arbough T, Dong M, et al. Molecular adsorbent recirculating system therapy with continuous renal replacement therapy enhanced clearance of piperacillin in a pediatric patient and led to failure to attain pharmacodynamic targets. Pharmacotherapy. 2020;40(10):1061\u20131068."},{"issue":"2","key":"i2331-348X-30-5-673-b13","series-title":"Clin Pharmacokinet","first-page":"209","article-title":"Pharmacokinetic alterations associated with critical illness","volume":"62","author":"Morales Castro","year":"2023","unstructured":"Morales Castro D, Dresser L, Granton J, Fan E. Pharmacokinetic alterations associated with critical illness. Clin Pharmacokinet. 2023;62(2):209\u2013220."},{"issue":"8","key":"i2331-348X-30-5-673-b14","series-title":"Pediatr Nephrol","first-page":"2817","article-title":"Current practices in pediatric continuous kidney replacement therapy: a systematic review-guided multinational modified Delphi consensus study","volume":"38","author":"Fuhrman","year":"2023","unstructured":"Fuhrman DY, Gist KM, Akcan-Arikan A. Current practices in pediatric continuous kidney replacement therapy: a systematic review-guided multinational modified Delphi consensus study. Pediatr Nephrol. 2023;38(8):2817\u20132826."},{"issue":"12","key":"i2331-348X-30-5-673-b15","series-title":"Am J Transplant","first-page":"4061","article-title":"Primary hyperoxaluria diagnosed after kidney transplant: a review of the literature and case report of aggressive renal replacement therapy and lumasiran to prevent allograft loss","volume":"21","author":"Stone","year":"2021","unstructured":"Stone HK, VandenHeuvel K, Bondoc A, et al. Primary hyperoxaluria diagnosed after kidney transplant: a review of the literature and case report of aggressive renal replacement therapy and lumasiran to prevent allograft loss. Am J Transplant. 2021;21(12):4061\u20134067."},{"issue":"7","key":"i2331-348X-30-5-673-b16","series-title":"N Engl J Med","first-page":"649","article-title":"Primary hyperoxaluria","volume":"369","author":"Cochat","year":"2013","unstructured":"Cochat P, Rumsby G. Primary hyperoxaluria. N Engl J Med. 2013;369(7):649\u2013658."},{"key":"i2331-348X-30-5-673-b17","series-title":"Front Pediatr","first-page":"1052625","article-title":"Lumasiran for primary hyperoxaluria type 1: what we have learned?","volume":"10","author":"Gang","year":"2023","unstructured":"Gang X, Liu F, Mao J. Lumasiran for primary hyperoxaluria type 1: what we have learned? Front Pediatr. 2023;10:1052625."},{"issue":"4","key":"i2331-348X-30-5-673-b18","series-title":"Am J Kidney Dis","first-page":"645","article-title":"Continuous dialysis therapies: core curriculum 2016","volume":"68","author":"Macedo","year":"2016","unstructured":"Macedo E, Mehta RL. Continuous dialysis therapies: core curriculum 2016. Am J Kidney Dis. 2016;68(4):645\u2013657."},{"key":"i2331-348X-30-5-673-b19","article-title":"PubChem Compound Summary for CID 71081, Oxalate","year":"2024","unstructured":"National Center for Biotechnology Information. PubChem Compound Summary for CID 71081, Oxalate. PubChem. 2024. Accessed August 5, 2024. https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/Oxalate"},{"issue":"4","key":"i2331-348X-30-5-673-b20","series-title":"J Clin Pharmacol","first-page":"565","article-title":"Demonstrating feasibility of an opportunistic sampling approach for pharmacokinetic studies of \u03b2\u2010lactam antibiotics in critically ill children","volume":"61","author":"Tang Girdwood","year":"2021","unstructured":"Tang Girdwood SC, Tang PH, Murphy ME, et al. Demonstrating feasibility of an opportunistic sampling approach for pharmacokinetic studies of \u03b2\u2010lactam antibiotics in critically ill children. J Clin Pharmacol. 2021;61(4):565\u2013573."},{"issue":"7","key":"i2331-348X-30-5-673-b21","series-title":"J Antimicrob Chemother","first-page":"2002","article-title":"Dose optimization of piperacillin\/tazobactam in critically ill children","volume":"72","author":"De Cock PAJG","year":"2017","unstructured":"De Cock PAJG, van Dijkman SC, de Jaeger A, et al. Dose optimization of piperacillin\/tazobactam in critically ill children. J Antimicrob Chemother. 2017;72(7):2002\u20132011."},{"key":"i2331-348X-30-5-673-b22","article-title":"FDA rationale for piperacillin-tazobactam breakpoints for Enterobacterales","year":"2023","unstructured":"US Food and Drug Administration. FDA rationale for piperacillin-tazobactam breakpoints for Enterobacterales. 2023. Accessed September 5, 2025. https:\/\/www.fda.gov\/drugs\/development-resources\/fda-rationale-piperacillin-tazobactam-breakpoints-enterobacterales"},{"key":"i2331-348X-30-5-673-b23","article-title":"M60\/M100\/M150 AND ST60\/ST100\/ST150 sets with AN 69 membrane for CRRT powered by PrisMax and Prismaflex","year":"2020","unstructured":"Baxter. M60\/M100\/M150 AND ST60\/ST100\/ST150 sets with AN 69 membrane for CRRT powered by PrisMax and Prismaflex. 2020. Accessed September 5, 2025. www.baxter.com"},{"issue":"12","key":"i2331-348X-30-5-673-b24","series-title":"J Clin Pharmacol","first-page":"1421","article-title":"Meropenem in children receiving continuous renal replacement therapy: clinical trial simulations using realistic covariates","volume":"54","author":"Nehus","year":"2014","unstructured":"Nehus EJ, Mouksassi S, Vinks AA, Goldstein S. Meropenem in children receiving continuous renal replacement therapy: clinical trial simulations using realistic covariates. J Clin Pharmacol. 2014;54(12):1421\u20131428."},{"issue":"3","key":"i2331-348X-30-5-673-b25","series-title":"Int J Antimicrob Agents","first-page":"107267","article-title":"Impact of fluid balance on beta-lactam antibiotics target attainment: insights from a simulation-based meropenem study","volume":"64","author":"Morales","year":"2024","unstructured":"Morales R, Mizuno T, Paice KM, et al. Impact of fluid balance on beta-lactam antibiotics target attainment: insights from a simulation-based meropenem study. Int J Antimicrob Agents. 2024;64(3):107267."},{"issue":"8","key":"i2331-348X-30-5-673-b26","series-title":"Antimicrob Agents Chemother","first-page":"1636","article-title":"Assessment of biliary excretion of piperacillin-tazobactam in humans","volume":"41","author":"Westphal","year":"1997","unstructured":"Westphal JF, Brogard JM, Caro-Sampara F, et al. Assessment of biliary excretion of piperacillin-tazobactam in humans. Antimicrob Agents Chemother. 1997;41(8):1636\u20131640."},{"issue":"5","key":"i2331-348X-30-5-673-b27","series-title":"Br J Clin Pharmacol","first-page":"682","article-title":"Nonlinear pharmacokinetics of piperacillin in healthy volunteers\u2013implications for optimal dosage regimens","volume":"70","author":"Bulitta","year":"2010","unstructured":"Bulitta JB, Kinzig M, Jakob V, et al. Nonlinear pharmacokinetics of piperacillin in healthy volunteers\u2013implications for optimal dosage regimens. Br J Clin Pharmacol. 2010;70(5):682\u2013693."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/30\/5\/article-p673.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/30\/5\/article-p673.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/30\/5\/article-p673.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T22:03:29Z","timestamp":1763762609000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/30\/5\/article-p673.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":27,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.5863\/jppt-24-00106","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"value":"2331-348X","type":"electronic"},{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}