title: New onset of multiple organ dysfunction after receiving long-term high-dose piperacillin for outpatient treatment of osteomyelitis.
abstract: Toxic side effects of piperacillin occur in many organ systems and may be cumulative dose related. We report a patient receiving long-term high-dose piperacillin to accommodate convenient outpatient intravenous therapy of osteomyelitis. He developed life-threatening multiorgan dysfunction on day 20 of piperacillin administration after 49 days of antibiotics, suggesting a likely adverse drug reaction. Piperacillin should be administered according to the manufacturer's recommendations of dosage, frequency and duration, and suggested monitoring. Unorthodox treatment regimens are discouraged.
authors.affiliation: University of Florida Health Sciences Center and Wolfson Children's Hospital, Jacksonville, FL; and the Henrietta Egleston Hospital for Children, Atlanta, GA.
authors.forename: Lucian K.
authors.initials: LK
authors.lastname: DeNicola
authors.forename: Bryan
authors.initials: B
authors.lastname: Blackwelder
authors.forename: Nagma
authors.initials: N
authors.lastname: Khan