Piperacillin-tazobactam combo causes no delay in MTX clearance

Co-administration of piperacillin and tazobactam (PIPC/TAZ) does not result in delayed methotrexate (MTX) clearance during high-dose MTX therapy, a study has shown. In addition, co-administration of cefepime with high-dose MTX had no impact on MTX clearance.

Using data from the JMDC database, a large insurance claims database constructed in Japan, a team of researchers sought to determine whether the co-administration of PIPC/TAZ or cefepime influences MTX clearance. They included patients who were prescribed PIPC/TAZ or cefepime between days 1 and 3 in high-dose MTX.

One co-administration episode (with PIPC/TAZ or cefepime) was compared to one control episode (without), as a match-control study of two different episodes in the same patient.

Duration and cumulative dose of leucovorin as a surrogate indicator of delayed MTX clearance were the primary outcomes.

Of the included patients, three were co-administered PIPC/TAX and 16 were co-administered cefepime with high-dose MTX.

The primary outcomes were comparable between co-administration and control episodes (duration: median 3.0 vs 3.0 days; cumulative dose: 288.0 vs 219.0 mg) in the PIPC/TAZ group. Likewise, in the cefepime group, duration and cumulative doses of leucovorin were similar between co-administration and control episodes (duration: 3.0 vs 4.0 days; cumulative doses: 169.5 vs 258.0 mg).

“Our findings revealed that PIPC/TAZ did not necessarily cause a delay in MTX clearance during HD-MTX therapy,” the researchers said. “Moreover, the co-administration of CFPM with high-dose MTX did not affect MTX clearance.”