[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-46511-en":3,"doc-seo-46511-105":30,"detail-sidebar-cat-0-en-105":95},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},46511,1099513958762,"Logic","https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1782109480056885918",8,"Research & Report","Impact of Piperacillin-Tazobactam Dosing in Septic Shock Patients Using Real-World Evidence","Sepsis and septic shock carry substantial morbidity and mortality, and early initiation of appropriate antibiotics is critical to reduce death risk. In practice, clinicians often reduce piperacillin-tazobactam doses due to concerns about renal dysfunction, yet evidence in septic shock is limited. This multicenter observational retrospective cohort study uses real-world EHR data to evaluate how early cumulative 48-hour dosing relates to clinical outcomes.","Author Manuscr ipt Author Manuscr ipt Author Manuscr ipt Author Manuscript  \n\n|  | HHS Public Access\u003Cbr>Author manuscript\u003Cbr>Ann Pharmacother. Author manuscript; available in PMC 2023 August 17. |\n| --- | --- |\n\nPublished in final edited form as:  \nAnn Pharmacother. 2023 June ; 57(6): 653–661. doi:10.1177/10600280221125919 .  \nImpact of Piperacillin-Tazobactam Dosing in Septic Shock Patients Using Real-World Evidence: An Observational, Retrospective Cohort Study  \nJohn M. Allen, PharmD, BCPS, BCCCP, FCCM, FCCP 1 , Devi Surajbali, PharmD2,* , Dalena Q. Nguyen, PharmD3,* , Jolanta Kuczek, PharmD4,* , Maithi Tran, PharmD5,* , Brianna Hachey, PharmD6,* , Carinda Feild, PharmD, FCCM 1 , Bethany R. Shoulders, PharmD, BCCCP 1 , Steven M. Smith, PharmD, MPH7 , Stacy A. Voils, PharmD, MS, BCPS, FCCM, FCCP8,†  \n1 Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, FL, USA  \n2Jackson Memorial Hospital, Miami, FL, USA  \n3Orlando VA Medical Center, Orlando, FL, USA  \n4 Publix Pharmacy, Orlando, FL, USA  \n5Winter Haven Hospital, Winter Haven, FL, USA  \n6Bay Pines VA Medical Center, Bay Pines, FL, USA  \n7 Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA  \n8Cardiovascular & Metabolism Medical Science Liaison, Syneos Health/Janssen, Gainesville, FL, USA  \nAbstract  \nBackground: Sepsis and septic shock are associated with significant morbidity and mortality.  \nRapid 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.  \nArticle reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)  \nCorresponding Author: John M. Allen, Department of Pharmacotherapy and Translational Research, University of Florida College  \nfAPhat thmacytime,6of5t5h  \nSanger Road, Suite 425, Orlando, FL 32827, [USA. john.allen@cop.ufl.edu](USA. john.allen@cop.ufl.edu).  \nconduct of the research, Drs Devi Surajbali, Dalena Q. Nguyen, Jolanta Kuczek, Maithi Tran, and Brianna Hachey  \nwere PharmD candidates at the University of Florida College of Pharmacy.  \n†At the time of the conduct of the research, Dr Stacy A. Voils was a Clinical Associate Professor at the Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy.  \nDeclaration of Conflicting Interests  \nThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.  \nSupplemental Material  \nSupplemental material for this article is available online.  \nAuthor Manuscr ipt Author Manuscr ipt Author Manuscr ipt Author Manuscript  \nAllen et al. Page 2  \nObjective: The purpose if this article is to investigate the rate and impact of piperacillintazobactam dose adjustment in early phase septic shock patients using real-world electronic health record (EHR) data.  \nMethods: A 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; \u003C27 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) .  \nResults: In 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 d","cbCaiisSdgB9v7X2","https://ap.wps.com/l/cbCaiisSdgB9v7X2","pdf",635565,4,1,17,"English","en",105,"# Abstract\n## Background\n## Objective\n## Methods\n## Results\n## Conclusions and Relevance\n## Keywords","[{\"question\":\"What clinical question does the study investigate?\",\"answer\":\"The study investigates the rate and impact of piperacillin-tazobactam dose adjustment in early-phase septic shock patients using real-world electronic health record data.\"},{\"question\":\"How were patients grouped for analysis?\",\"answer\":\"Patients were stratified by cumulative 48-hour piperacillin-tazobactam dose into a low-dose group (\\u003c27 g) and a normal-dose group (≥27 g), with propensity score matching to address confounding.\"},{\"question\":\"What was the primary outcome and what did it show?\",\"answer\":\"The primary outcome was 28-day norepinephrine-free days (NFD). In the propensity score–matched cohort, the NORM group had significantly more median NFD (23.9 vs 13.6 days).\"},{\"question\":\"What are the study’s key clinical implications?\",\"answer\":\"Early piperacillin-tazobactam dose reduction in septic shock is associated with worsened clinical outcomes, supporting vigilance to avoid unnecessary early dose reductions.\"}]",1783544894,43,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":90,"head_meta":92,"extra_data":94,"updated_unix":28},"impact-of-piperacillin-tazobactam-dosing-in-septic-shock-patients-using-real-world-evidence","",{"@graph":36,"@context":89},[37,53,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/research-report/",3,{"item":52,"name":13,"@type":43,"position":20},"https://docshare.wps.com/document/impact-of-piperacillin-tazobactam-dosing-in-septic-shock-patients-using-real-world-evidence/46511/",{"url":52,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":24,"description":14,"dateModified":61,"datePublished":62,"encodingFormat":60,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":41,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-20","2026-07-08",true,{"@type":65,"interactionType":66,"userInteractionCount":20},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81,85],{"name":72,"@type":73,"acceptedAnswer":74},"What clinical question does the study investigate?","Question",{"text":75,"@type":76},"The study investigates the rate and impact of piperacillin-tazobactam dose adjustment in early-phase septic shock patients using real-world electronic health record data.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"How were patients grouped for analysis?",{"text":80,"@type":76},"Patients were stratified by cumulative 48-hour piperacillin-tazobactam dose into a low-dose group (\u003C27 g) and a normal-dose group (≥27 g), with propensity score matching to address confounding.",{"name":82,"@type":73,"acceptedAnswer":83},"What was the primary outcome and what did it show?",{"text":84,"@type":76},"The primary outcome was 28-day norepinephrine-free days (NFD). In the propensity score–matched cohort, the NORM group had significantly more median NFD (23.9 vs 13.6 days).",{"name":86,"@type":73,"acceptedAnswer":87},"What are the study’s key clinical implications?",{"text":88,"@type":76},"Early piperacillin-tazobactam dose reduction in septic shock is associated with worsened clinical outcomes, supporting vigilance to avoid unnecessary early dose reductions.","https://schema.org",{"og:url":52,"og:type":91,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":93,"canonical":52},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":96},[97,101,105,109,114,119,124,127,132,135,139],{"id":21,"doc_module":4,"doc_module_name":46,"category_name":98,"show_sort_weight":99,"slug":100},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":102,"show_sort_weight":103,"slug":104},"Literature",80,"literature",{"id":20,"doc_module":4,"doc_module_name":46,"category_name":106,"show_sort_weight":107,"slug":108},"Exam",70,"exam",{"id":110,"doc_module":4,"doc_module_name":46,"category_name":111,"show_sort_weight":112,"slug":113},5,"Comic",60,"comic",{"id":115,"doc_module":4,"doc_module_name":46,"category_name":116,"show_sort_weight":117,"slug":118},6,"Technology",50,"technology",{"id":120,"doc_module":4,"doc_module_name":46,"category_name":121,"show_sort_weight":122,"slug":123},7,"Healthcare",40,"healthcare",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":125,"slug":126},30,"research-report",{"id":128,"doc_module":4,"doc_module_name":46,"category_name":129,"show_sort_weight":130,"slug":131},9,"Religion & Spirituality",20,"religion-spirituality",{"id":130,"doc_module":4,"doc_module_name":46,"category_name":133,"show_sort_weight":130,"slug":134},"World Cup","world-cup",{"id":136,"doc_module":4,"doc_module_name":46,"category_name":137,"show_sort_weight":136,"slug":138},10,"Lifestyle","lifestyle",{"id":140,"doc_module":4,"doc_module_name":46,"category_name":141,"show_sort_weight":110,"slug":142},19,"General","general"]