Altered Pharmacokinetics of Piperacillin in Febrile Neutropenic Patients with Hematological Malignancy

This study assessed the pharmacokinetics and dosing adequacy of piperacillin in febrile neutropenic patients after the first dose. Pharmacokinetic analysis was performed using noncompartmental methods. We observed an elevated volume of distribution (29.7 +/- 8.0 liters [mean +/- standard deviation]) and clearance (20.2 +/- 7.5 liters/h) compared to data from other patient populations. Antibiotic exposure did not consistently result in therapeutic targets. We conclude that alternative dosing strategies guided by therapeutic drug monitoring may be required to optimize exposure.