Evidence map›Paper›PMID 36154486›Full record

Observational studyThe Annals of pharmacotherapy2023

Impact of Piperacillin-Tazobactam Dosing in Septic Shock Patients Using Real-World Evidence: An Observational, Retrospective Cohort Study.

John M Allen, Devi Surajbali, Dalena Q Nguyen, Jolanta Kuczek, Maithi Tran, Brianna Hachey, Carinda Feild, Bethany R Shoulders, Steven M Smith, Stacy A Voils

Open access · greenAbstract readObservational StudyMulticenter Study
In one paragraph

Observational study in The Annals of pharmacotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 1 country.

John M AllenDepartment of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, FL, USA.ORCID 0000-0002-0033-4508
Devi SurajbaliJackson Memorial Hospital, Miami, FL, USA.
Dalena Q NguyenOrlando VA Medical Center, Orlando, FL, USA.
Jolanta KuczekPublix Pharmacy, Orlando, FL, USA.
Maithi TranWinter Haven Hospital, Winter Haven, FL, USA.
Brianna HacheyBay Pines VA Medical Center, Bay Pines, FL, USA.
Carinda FeildDepartment of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, FL, USA.
Bethany R ShouldersDepartment of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, FL, USA.ORCID 0000-0002-0466-1450
Steven M SmithDepartment of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA.ORCID 0000-0002-0201-839X
Stacy A VoilsCardiovascular & Metabolism Medical Science Liaison, Syneos Health/Janssen, Gainesville, FL, USA.
University of Florida · USBay Pines VA Healthcare System · USJackson Memorial Hospital · USOrlando VA Medical Center · USSyneos Health (United States) · USWinter Haven Hospital · US

Funding

Using social networks to map and evaluate team science across CTSA hubsUL1TR001427 · NCATS · UNIVERSITY OF FLORIDA · PI MITCHELL, DUANE A. · 2015 to 2024
$37.2M
NCATS NIH HHS UL1 TR001427
6 · The paper itself

Abstract

backgroundSepsis and septic shock are associated with significant morbidity and mortality. Rapid initiation of appropriate antibiotic therapy is essential, as inadequate therapy early during septic shock has been shown to increase the risk of mortality. However, despite the importance of appropriate antibiotic initiation, in clinical practice, concerns for renal dysfunction frequently lead to antibiotic dose reduction, with scant evidence on the impact of this practice in septic shock patients.

objectiveThe purpose if this article is to investigate the rate and impact of piperacillin-tazobactam dose adjustment in early phase septic shock patients using real-world electronic health record (EHR) data.

methodsA multicenter, observational, retrospective cohort study was conducted of septic shock patients who received at least 48 hours of piperacillin-tazobactam therapy and concomitant receipt of norepinephrine. Subjects were stratified into 2 groups according to their cumulative 48-hour piperacillin-tazobactam dose: low piperacillin-tazobactam dosing (LOW; <27 g) group and normal piperacillin-tazobactam dosing (NORM; ≥27 g) group. To account for potential confounding variables, propensity score matching was used. The primary study outcome was 28-day norepinephrine-free days (NFD).

resultsIn all, 1279 patients met study criteria. After propensity score matching (n = 608), the NORM group had more median NFD (23.9 days [interquartile range, IQR: 0-27] vs 13.6 days [IQR: 0-27], CONCLUSIONS AND RELEVANCE: In the propensity score-matched cohort, the NORM group had significantly more 28-day NFD. Piperacillin-tazobactam dose reduction in early phase septic shock is associated with worsened clinical outcomes. Clinicians should be vigilant to avoid piperacillin-tazobactam dose reduction in early phase septic shock.

Indexed as

PiperacillinShock, SepticAnti-Bacterial AgentsCarubicinHumansPenicillanic AcidPiperacillin, Tazobactam Drug CombinationRetrospective StudiesTazobactamAnti-Bacterial AgentsCarubicinN-formyl-13-dihydrocarminomycinPenicillanic AcidPiperacillinPiperacillin, Tazobactam Drug CombinationTazobactamantibacterial agentscritical carepiperacillin-tazobactamrenalsepsisseptic shock

Identifiers

PMID36154486
PMCPMC10433263
OpenAlexW4297235855

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.