This retrospective cohort study included 53 patients admitted in ICU, of average age 69 years, without neurologic disorder before initiation of piperacillin continuous infusion at standard dose and who underwent piperacillin serum concentration monitoring. Among them, 23 developed neurologic disorder for which the piperacillin causality was chronologically and semiologically suggestive. A concentration threshold of 157.2 mg/L independently predicted neurotoxicity with 96.7% specificity and 52.2% sensitivity and may constitute a limitation when targeting less susceptible pathogens.
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