MARS therapy leads to a considerable reduction (34%) in plasma piperacillin concentrations per treatment session in critically ill patients with acute or acute-on-chronic liver failure.
Higher creatinine clearance correlates with increased piperacillin loss during MARS, while elevated bilirubin is associated with reduced drug clearance.
Approximately one-third of post-MARS piperacillin concentrations fell below the therapeutic target, potentially risking suboptimal antimicrobial exposure.
Findings advocate for systematic therapeutic drug monitoring (TDM) and tailored antibiotic dosing during MARS therapy to ensure efficacy.
