{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:51:36Z","timestamp":1788259896666,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005111","name":"Rigshospitalet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005111","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Critically ill patients in intensive care units (ICU) are frequently administered broad\u2010spectrum antibiotics (e.g., carbapenems or piperacillin\/tazobactam) for suspected or confirmed infections. This retrospective cohort study aimed to describe the use of carbapenems and piperacillin\/tazobactam in two international, prospectively collected datasets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a post hoc analysis of data from the \u201cAdjunctive Glucocorticoid Therapy in Patients with Septic Shock\u201d (ADRENAL) trial (<jats:italic>n<\/jats:italic>\u2009=\u20093713) and the \u201cAntimicrobial de\u2010escalation in the critically ill patient and assessment of clinical cure\u201d (DIANA) study (<jats:italic>n<\/jats:italic>\u2009=\u20091488). The primary outcome was the proportion of patients receiving initial antibiotic treatment with carbapenems and piperacillin\/tazobactam. Secondary outcomes included mortality, days alive and out of ICU and ICU length of stay at 28\u2009days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the ADRENAL trial, carbapenems were used in 648 out of 3713 (17%), whereas piperacillin\/tazobactam was used in 1804 out of 3713 (49%) participants. In the DIANA study, carbapenems were used in 380 out of 1480 (26%), while piperacillin\/tazobactam was used in 433 out of 1488 (29%) participants. Mortality at 28\u2009days was 23% for patients receiving carbapenems and 24% for those receiving piperacillin\/tazobactam in ADRENAL and 23% and 19%, respectively, in DIANA. We noted variations in secondary outcomes; in DIANA, patients receiving carbapenems had a median of 13\u2009days alive and out of ICU compared with 18\u2009days among those receiving piperacillin\/tazobactam. In ADRENAL, the median hospital length of stay was 27\u2009days for patients receiving carbapenems and 21\u2009days for those receiving piperacillin\/tazobactam.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this post hoc analysis of ICU patients with infections, we found widespread initial use of carbapenems and piperacillin\/tazobactam in international ICUs, with the latter being more frequently used. Randomized clinical trials are needed to assess if the observed variations in outcomes may be drug\u2010related effects or due to confounders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14419","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T06:49:26Z","timestamp":1711694966000},"page":"821-829","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Empirical carbapenems or piperacillin\/tazobactam for infections in intensive care: An international retrospective cohort study"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4761-3228","authenticated-orcid":false,"given":"Nick","family":"Meier","sequence":"first","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1127-9599","authenticated-orcid":false,"given":"Marie Warrer","family":"Munch","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5799-7655","authenticated-orcid":false,"given":"Anders","family":"Granholm","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Perner","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0888-4616","authenticated-orcid":false,"given":"Frederik Bo\u00ebtius","family":"Hertz","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Immunology &amp; Microbiology University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balasubramanian","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Critical Care Program, The George Institute for Global Health University of New South Wales  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi E.","family":"Hammond","sequence":"additional","affiliation":[{"name":"Critical Care Program, The George Institute for Global Health University of New South Wales  Sydney New South Wales 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