{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:33:36Z","timestamp":1788406416354,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T00:00:00Z","timestamp":1664064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001427"],"award-info":[{"award-number":["UL1TR001427"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Sepsis 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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; &lt;27 g) group and normal piperacillin-tazobactam dosing (NORM; \u226527 g) group. To account for potential confounding variables, propensity score matching was used. The primary study outcome was 28-day norepinephrine-free days (NFD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      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 days [IQR: 0-27],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.021). The NORM group also had lower rates of in-hospital mortality\/hospice disposition (25.9% [n = 79] vs 35.5% [n = 108]),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.014). Other secondary outcomes were similar between the treatment groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance:<\/jats:title>\n                    <jats:p>In the propensity score\u2013matched 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280221125919","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T02:19:16Z","timestamp":1664158756000},"page":"653-661","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Piperacillin-Tazobactam Dosing in Septic Shock Patients Using Real-World Evidence: An Observational, Retrospective Cohort Study"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0033-4508","authenticated-orcid":false,"given":"John M.","family":"Allen","sequence":"first","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devi","family":"Surajbali","sequence":"additional","affiliation":[{"name":"Jackson Memorial Hospital, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalena","family":"Q. Nguyen","sequence":"additional","affiliation":[{"name":"Orlando VA Medical Center, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Kuczek","sequence":"additional","affiliation":[{"name":"Publix Pharmacy, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maithi","family":"Tran","sequence":"additional","affiliation":[{"name":"Winter Haven Hospital, Winter Haven, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Hachey","sequence":"additional","affiliation":[{"name":"Bay Pines VA Medical Center, Bay Pines, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carinda","family":"Feild","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0466-1450","authenticated-orcid":false,"given":"Bethany R.","family":"Shoulders","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0201-839X","authenticated-orcid":false,"given":"Steven M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy A.","family":"Voils","sequence":"additional","affiliation":[{"name":"Cardiovascular &amp; Metabolism Medical Science Liaison, Syneos Health\/Janssen, Gainesville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,9,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201504-0781OC."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00627-10."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.4161\/viru.27372."},{"key":"e_1_3_3_6_2","unstructured":"Zosyn (piperacillin-tazobactam) [package insert]. Philadelphia PA: Wyeth Pharmaceuticals LLC; 2021."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009487."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31827e83af."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002255."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2018.05.003."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000180580."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907118."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01347-15."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001843."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.28.1.1."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/0018578719889025."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.02.058."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002377."},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12222."},{"key":"e_1_3_3_21_2","first-page":"48","article-title":"Dosing errors of empirical antibiotics in critically ill patients with severe sepsis or septic shock: a prospective observational study","volume":"13","author":"Al-Dorzi HM","year":"2019","unstructured":"Al-Dorzi HM, Eissa AT, Khan RM, Harbi SAA, Aldabbagh T, Arabi YM. Dosing errors of empirical antibiotics in critically ill patients with severe sepsis or septic shock: a prospective observational study. Int J Health Sci (Qassim). 2019;13:48-55.","journal-title":"Int J Health Sci (Qassim)"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy790."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000400."},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2018.11.024."},{"key":"e_1_3_3_25_2","article-title":"Rothman index on admission to the medical intensive care unit: a strong predictor of outcomes","volume":"195","author":"Fakih HAM","year":"2017","unstructured":"Fakih HAM, Faruqi I. Rothman index on admission to the medical intensive care unit: a strong predictor of outcomes. Am J Respir Crit Care Med. 2017;195:A6813.","journal-title":"Am J Respir Crit Care Med"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0847-3."},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005337."},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003004."},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2006.02.011."},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-1396."},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki243."},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02759-14."},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/jac5.1084."},{"key":"e_1_3_3_34_2","first-page":"957","article-title":"Is high-dose beta-lactam therapy associated with excessive drug toxicity in critically ill patients?","volume":"82","author":"McDonald C","year":"2016","unstructured":"McDonald C, Cotta MO, Little PJ, et al. Is high-dose beta-lactam therapy associated with excessive drug toxicity in critically ill patients? Minerva Anestesiol. 2016;82:957-965.","journal-title":"Minerva Anestesiol"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10600280221125919","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10600280221125919","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10600280221125919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:17:07Z","timestamp":1777375027000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10600280221125919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,25]]},"references-count":33,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1177\/10600280221125919"],"URL":"https:\/\/doi.org\/10.1177\/10600280221125919","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,25]]}}}