|
Corrected Gestational Age/Postmenstrual Age
|
| bet | 477/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Corrected Gestational Age/Postmenstrual Age
|
Dose
|
Interval
|
< 30+0 weeks
|
100 mg/kg/dose
|
8 hourly
|
30+0−35+6 weeks
|
80 mg /kg/dose
|
6 hourly
|
≥ 36+0 weeks*
|
80 mg/kg/dose
|
6 hourly
|
*Consider 4 hourly dosing if culture-proven sepsis in this group
|
Dose adjustment
|
Therapeutic hypothermia – Evidence is lacking to guide dose adjustment.
ECMO – While standard dosing may be adequate for susceptible organisms, studies in adults have shown poor PK target attainment for the directed therapy of Pseudomonas aeruginosa. Seek infectious diseases consultant advice(5, 6)
Renal impairment – Use with caution. Concurrent use with vancomycin has been suggested to be associated with an increased incidence of acute kidney injury in adults and children but unclear in neonates. (7-11)
Hepatic impairment – No dose adjustment is required.
|
Maximum dose
|
|
Total cumulative dose
|
|
Route
|
IV
|
Preparation
|
Add 17 mL water for injection to the 4.5 g vial to make a concentration of 200 mg/mL of piperacillin equivalent solution.
FURTHER DILUTE
Draw up 2 mL (400 mg of piperacillin equivalent) and add 8 mL of sodium chloride 0.9% to make a final volume of 10 mL with a final concentration of 40 mg/mL of piperacillin equivalent.
|
Administration
|
IV infusion over 30 minutes. (3)
|
Monitoring
|
Complete blood count, electrolytes, renal and hepatic function during prolonged treatment (> 10 days).
|
Contraindications
|
Hypersensitivity to any of the penicillins and/or cephalosporins or beta-lactamase inhibitors.
|
Precautions
|
Prolonged therapy increases risk of leucopenia, neutropenia and thrombocytopenia. High doses may lead to hypernatraemia (owing to sodium content of preparations) (12)
|
|
| |
