{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:53:08Z","timestamp":1777859588284,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Piperacillin-tazobactam (PTZ) demonstrates time-dependent bactericidal activity, potentially increasing the need for higher dosing in obese and critically ill patients. However, limited information is available on the safety of higher dosing strategies.\n                    <jats:bold>Objective:<\/jats:bold>\n                    To evaluate the safety and clinical impact of high dose 6.75\u00a0g IV PTZ for the treatment of pneumonia in critically ill, obese (\u2265120\u00a0kg) patients vs standard dose 4.5\u00a0g IV PTZ.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Retrospective, cohort study, multicenter in health-system consisting of four acute-care teaching hospitals. Adult patients weighing at least 120\u00a0kg on PTZ for pneumonia in the intensive care unit (ICU) from January 2013 to September 2018 were included. The primary outcome of the study was acute nephrotoxicity defined as initiation of renal replacement therapy and\/or serum creatinine increase within 48\u00a0hours of last PTZ dose. Secondary outcomes included thrombocytopenia, 14-day all-cause mortality, and ICU length of stay (LOS).\n                    <jats:bold>Results:<\/jats:bold>\n                    One hundred thirty-six patients were included with 52 and 84 in 4.5\u00a0g PTZ and 6.75\u00a0g PTZ respectively. The rate of acute nephrotoxicity was comparable between cohorts (50% 4.5\u00a0g vs 40.5% 6.75\u00a0g,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.277). High dose PTZ was not independently associated with acute nephrotoxicity after control for selected confounders. All secondary outcomes were similar. Concomitant vancomycin and calculated supratherapeutic vancomycin area under curve were not independently associated with increased nephrotoxicity.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    High dose PTZ was not associated with increased acute nephrotoxicity, thrombocytopenia, 14-day all-cause mortality, or ICU LOS. Additionally, more robust trials are needed to fully assess the clinical impact of 6.75\u00a0g PTZ dosing for critically ill, obese patients, for pneumonia.\n                  <\/jats:p>","DOI":"10.1177\/08971900251319072","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T17:43:41Z","timestamp":1738604621000},"page":"444-451","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Retrospective Study Evaluating the Safety and Clinical Impact of High Dose (6.75\u00a0grams) Piperacillin-Tazobactam Dosing in Critically Ill Obese Patients for Pneumonia"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6556-9196","authenticated-orcid":false,"given":"Christina X.","family":"Tran","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Methodist Dallas Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6353-2958","authenticated-orcid":false,"given":"Matthew P.","family":"Crotty","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Methodist Dallas Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4691-1232","authenticated-orcid":false,"given":"Ronda L.","family":"Akins","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Methodist Charlton Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.505"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00656-13"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02513-12"},{"key":"e_1_3_5_5_2","unstructured":"Hales CM Carroll MD Fryar CD Ogden CL. 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