{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:08:01Z","timestamp":1756426081710,"version":"3.44.0"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Hosp Pharm"],"abstract":"<jats:p>Background: In critically ill patients, pharmacokinetic variability can lead to inadequate antimicrobial concentrations. Antimicrobial resistance to \u03b2-lactam antibiotics is increasing among the nonfermenting gram- negative bacilli (NFGNB). Current guidelines recommend optimizing \u03b2-lactam pharmacokinetics\/pharmacodynamics with prolonged infusion of these antibiotics. In 2019, a protocol for continuous infusion of piperacillin\u2013tazobactam (P\/T) was implemented in 2 intensive care units (ICUs) as a quality improvement initiative.\nObjectives: The primary objective was to describe and evaluate implementation of the practice change to continuous infusion of P\/T. The secondary objectives were to describe ICU mortality and length of stay (LOS), identify safety incidents related to the protocol, and determine the prevalence of NFGNB and associated minimum inhibitory concentrations of P\/T.\nMethods: This single-centre retrospective study involved a convenience sample of 200 patients who received 2 or more doses of P\/T during an ICU admission between October 2020 and October 2022. Data on drug administration, characteristics of the hospital stay, and patient outcomes were collected from patients\u2019 digital records and the Critical Care Database of the study institution. Eight criteria for successful implementation of the protocol were established, with implementation deemed successful if at least 6 of these criteria were met.\nResults: Implementation of the continuous-infusion protocol was successful for 156 (78.0%) of the 200 ICU patients, 41 (20.5%) of the patients died during the ICU admission, and the median LOS in the ICU was 4.9 (interquartile range 2.4\u201310.7) days. No safety incidents were identified. The prevalence of NFGNB was 3.1% for all ICU patients over the 2-year study period.\nConclusions: Implementation of the continuous-infusion protocol was successful in most patients. Areas for improvement include editing the order set, providing interprofessional education, and enhancing interprofessional collaboration.\nKeywords: continuous infusion, piperacillin\u2013tazobactam, critical care\nR\u00c9SUM\u00c9\nContexte : Chez les patients gravement malades, la variabilit\u00e9 pharmacocin\u00e9tique peut entra\u00eener des concentrations insuffisantes d\u2019antimicrobiens. La r\u00e9sistance antimicrobienne aux antibiotiques\u03b2-lactamines augmente parmi les bacilles \u00e0 Gram n\u00e9gatif non fermentescibles(BGNnF). Les recommandations actuelles pr\u00e9conisent d\u2019optimiser la pharmacocin\u00e9tique\/pharmacodynamique des \uf062-lactamines avec des perfusions prolong\u00e9es des antibiotiques \u03b2-lactamines. En 2019, un protocole continu de pip\u00e9racilline-tazobactam (P\/T) a \u00e9t\u00e9 mis en place dans 2 unit\u00e9s de soins intensifs (USI) dans le cadre d\u2019une initiative d\u2019am\u00e9lioration de la qualit\u00e9.\nObjectifs : L\u2019objectif principal consistait \u00e0 d\u00e9crire et \u00e0 \u00e9valuer la mise en \u0153uvre du changement de pratique vers les perfusions continues de pip\u00e9racilline-tazobactam (P\/T). L\u2019objectif secondaire consistait, quant \u00e0 lui, \u00e0 d\u00e9crire la mortalit\u00e9 en USI, la dur\u00e9e du s\u00e9jour (DDS), les incidents de s\u00e9curit\u00e9 li\u00e9s au protocole, ainsi que la pr\u00e9valence des BGNnF et les concentrations minimales inhibitrices associ\u00e9es de P\/T.\nM\u00e9thodologie : Cette \u00e9tude r\u00e9trospective monocentrique impliquait un \u00e9chantillon de convenance de 200 patients ayant re\u00e7u 2 doses ou plus de P\/T lors d\u2019une admission en USI entre octobre 2020 et octobre 2022. Les donn\u00e9es sur l\u2019administration des m\u00e9dicaments, les caract\u00e9ristiques du s\u00e9jour \u00e0 l\u2019h\u00f4pital et les r\u00e9sultats des patients ont \u00e9t\u00e9 recueillis \u00e0 partir des dossiers num\u00e9riques des patients et de la base de donn\u00e9es des soins intensifs de l\u2019institution de l\u2019\u00e9tude. Huit crit\u00e8res de mise en \u0153uvre r\u00e9ussie du protocole ont \u00e9t\u00e9 d\u00e9finis. Pour que la mise en \u0153uvre soit consid\u00e9r\u00e9e comme r\u00e9ussie, il fallait respecter au moins 6 crit\u00e8res.\nR\u00e9sultats : La mise en \u0153uvre du protocole de perfusion continue a \u00e9t\u00e9 r\u00e9ussie pour 156 (78,0 %) des 200 patients en USI, 41 (20,5 %) des patients sont d\u00e9c\u00e9d\u00e9s lors de leur admission en USI et la DDS m\u00e9diane en USI \u00e9tait de 4,9 jours (intervalle interquartile de 2,4 \u00e0 10,7 jours). Aucun incident de s\u00e9curit\u00e9 n\u2019a \u00e9t\u00e9 identifi\u00e9. La pr\u00e9valence des BGNnF \u00e9tait de 3,1 % pour tous les patients en USI pendant la p\u00e9riode d\u2019\u00e9tude de 2 ans.\nConclusions : La mise en \u0153uvre du protocole de perfusion continue a \u00e9t\u00e9 r\u00e9ussie pour la plupart des patients. Les domaines d\u2019am\u00e9lioration comprennent la modification de l\u2019ensemble de commandes, l\u2019offre de formations interprofessionnelles et le renforcement de la collaboration interprofessionnelle.\nMots-cl\u00e9s : perfusion continue, pip\u00e9racilline-tazobactam, soins intensifs<\/jats:p>","DOI":"10.4212\/cjhp.3710","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T20:10:09Z","timestamp":1756411809000},"source":"Crossref","is-referenced-by-count":0,"title":["Implementation of Piperacillin\u2013Tazobactam Continuous Infusions for Critically Ill Patients: A Single-Centre Retrospective Chart Review"],"prefix":"10.4212","volume":"78","author":[{"given":"Kylie","family":"Landry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"MacKenzie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Burgess","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bonnar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yahya","family":"Shabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Patriquin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volker","family":"Eichhorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolynn","family":"Holland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2025,8,13]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3710\/5691","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3710\/5692","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3710\/5691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T20:10:11Z","timestamp":1756411811000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,7,9]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3710","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2025,8,13]]},"article-number":"e3710"}}