Early piperacillin exposure during continuous infusion in critically ill patients: the impact of renal and liver dysfunctions
Authors' conclusion
Only one-third of critically ill patients achieved target piperacillin exposure at initial therapeutic drug monitoring during continuous infusion. Early deviations from target concentrations were frequent and primarily determined by renal dysfunction despite routine dose adjustment.
Study context
- Population
- Consecutive adult critically ill patients receiving continuous-infusion piperacillin-tazobactam with ≥1 total plasma piperacillin measurement, 20-bed medical-surgical ICU of a university hospital775 piperacillin measurements
- Participants
- 350 patients
- Outcome
- Piperacillin exposure at first sampling
- Follow-up
- Day 1
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
Underexposed
30%
Target range achieved
35%
Overexposed
35%
Observational data: associations, not effects.
Further findings
Determinants of underexposure (multivariable analyses)
- Underexposure less frequent in older patients and in those with renal dysfunction or shock; male sex independently associated with higher risk of underexposure
Determinants of overexposure (multivariable analyses)
- Overexposure strongly associated with renal dysfunction, higher bilirubin and higher daily piperacillin dose
Piperacillin concentrations by organ dysfunction phenotype
- Highest in patients with combined hepato-renal dysfunction
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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