
Ventriculitis in neurocritical care patients contributes to significant morbidity and mortality. This study aimed to develop a population pharmacokinetic (PK) model to optimize piperacillin-tazobactam (PTZ) dosing for cerebrospinal fluid (CSF) exposure in critically ill neurosurgical patients. Eight patients with external ventricular drains receiving PTZ were analyzed. Substantial PK variability was observed, especially in CSF. The median CSF penetration for piperacillin was 3.73%, and tazobactam penetration was unpredictable. Due to this variability and low drug penetration into CSF, optimal dosing recommendations for ventriculitis treatment could not be established. High plasma PTZ levels may not ensure effective CSF exposures.
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