Impact of unbound fraction variations on piperacillin clearance and dosing recommendations
Individual CL estimates are summarized in Table 1. For example, for the first renal function category, a patient with a CLCr of 24.7 mL/min was selected for this evaluation. The estimated piperacillin CL for this subject decreased as unbound fraction increased, ranging from 5.1 L/h for an unbound fraction of 70% to 4.0 L/h for an unbound fraction of 85%. After simulating a loading dose of 4 g accompanied by a maintenance dose of 8 g, PK/PD target attainment was reached successfully, as illustrated in Figure 2. Similar results were obtained for the other three categories of patients and are available in Table 1 and Figure 2.