ํ”ผํŽ˜๋ผ์‹ค๋ฆฐ/ํƒ€์กฐ๋ฐ•ํƒ / Piperacillin-tazobactam

์ •์˜

ํ”ผํŽ˜๋ผ์‹ค๋ฆฐ/ํƒ€์กฐ๋ฐ•ํƒ์€ ๊ด‘๋ฒ”์œ„ ๋ฒ ํƒ€๋ฝํƒ/๋ฒ ํƒ€๋ฝํƒ€๋งˆ์ œ ์–ต์ œ์ œ ์กฐํ•ฉ ํ•ญ์ƒ์ œ์ด๋ฉฐ ๊ตญ๋‚ด ์ž„์ƒ์—์„œ Tazo๋กœ ์ž์ฃผ ์ง€์นญ๋œ๋‹ค.

์ž„์ƒ ํ•ต์‹ฌ

์ „์› ์˜จ sepsis ํ™˜์ž๊ฐ€ ์ด๋ฏธ ์ ์ ˆํ•œ ์šฉ๋Ÿ‰์„ ๋งž์€ ๊ฒƒ์ด ํ™•์ธ๋˜๋ฉด ๋„์ฐฉ ์ฆ‰์‹œ ์ค‘๋ณต ํˆฌ์—ฌํ•  ํ•„์š”๋Š” ๋ณดํ†ต ์—†๋‹ค. ๋งˆ์ง€๋ง‰ ํˆฌ์—ฌ ์‹œ์ž‘/์ข…๋ฃŒ ์‹œ๊ฐ, ์šฉ๋Ÿ‰, infusion ์‹œ๊ฐ„, CrCl/eGFR, ํ˜ˆ์•ก๋ฐฐ์–‘ ์ฑ„์ทจ ์—ฌ๋ถ€๋ฅผ ํ™•์ธํ•œ๋‹ค. ํˆฌ์—ฌ ์‹œ๊ฐ์ด ๋ถˆ๋ช…ํ™•ํ•˜๊ฑฐ๋‚˜ missed dose ๊ฐ€๋Šฅ์„ฑ์ด ์žˆ๊ฑฐ๋‚˜ septic shock/high-likelihood sepsis์ด๋ฉด ์ง€์—ฐ๋ณด๋‹ค ์ฆ‰์‹œ ๊ฒฝํ—˜์  ๊ด‘๋ฒ”์œ„ ์ปค๋ฒ„๊ฐ€ ์šฐ์„ ์ด๋‹ค. Tazo spectrum์ด source์— ๋ถ€์กฑํ•˜๋ฉด MRSA ์œ„ํ—˜์—์„œ๋Š” vancomycin ๋“ฑ์„ ์ถ”๊ฐ€ํ•˜๊ณ , ESBL/CRE ์œ„ํ—˜ ๋˜๋Š” ์ค‘์ฆ healthcare-associated/intra-abdominal infection์—์„œ๋Š” escalation์„ ๊ณ ๋ คํ•œ๋‹ค.

์ง„๋‹จ

ํ•ญ์ƒ์ œ ์ž์ฒด์˜ ์ง„๋‹จ ํ•ญ๋ชฉ์€ ์—†์ง€๋งŒ, sepsis bundle ๋งฅ๋ฝ์—์„œ culture, lactate trend, source ํ‰๊ฐ€๊ฐ€ ํ•จ๊ป˜ ํ•„์š”ํ•˜๋‹ค.

์น˜๋ฃŒ

์„ฑ์ธ ์ •์ƒ ์‹ ๊ธฐ๋Šฅ์—์„œ label์ƒ ์ผ๋ฐ˜ ์ ์‘์ฆ์€ 3.375 g IV q6h 30๋ถ„ infusion, ๋ณ‘์›ํš๋“/๋…น๋†๊ท  ํ๋ ด ์ปค๋ฒ„๋Š” 4.5 g IV q6h ๊ธฐ์ค€์ด๋‹ค. CrCl โ‰ค40์ด๋ฉด ๊ฐ๋Ÿ‰์ด ํ•„์š”ํ•˜๋‹ค. Extended infusion ํ”„๋กœํ† ์ฝœ์€ q8h ๋“ฑ์œผ๋กœ ๋‹ค๋ฅผ ์ˆ˜ ์žˆ์–ด local renal-dose protocol์„ ๋”ฐ๋ฅธ๋‹ค.

์ถœ์ฒ˜

DailyMed piperacillin/tazobactam label ๋ฐ SSC 2021 time-to-antimicrobials ์›์น™์— ๊ทผ๊ฑฐํ•œ๋‹ค.

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