Prolonged elimination of piperacillin in a patient with renal and liver failure

A 22-year-old female with acute leukemia was admitted to the oncology center for evaluation and treatment. Piperacillin was used during her admission for treatment of Pseudomonal sepsis. The patient's renal and liver function deteriorated during the hospital course, requiring large dose adjustments of piperacillin. The elimination half-life of piperacillin was estimated to be 32 hours. Patients with both liver and renal disease require only small doses of piperacillin to achieve therapeutic plasma concentration.