Antibiotic stewardship program in Intensive Care Unit: First report from Iran

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Pharmacology

Background:

• Limited data exist on antibiotic stewardship programs for critically ill patients.
• This study evaluated empirical antibiotic regimens in sepsis patients.

Purpose of the Study:

• To compare meropenem (carbapenem) with piperacillin-tazobactam (non-carbapenem) for empirical antibiotic therapy in critically ill sepsis patients.
• To assess the impact of switching empirical antibiotics on clinical response and bacterial eradication.

Main Methods:

• An open-label randomized clinical trial involving 100 critically ill patients with suspected sepsis.
• Patients received either meropenem or piperacillin-tazobactam as empirical treatment.
• Clinical response and bacterial eradication rates were primary and secondary outcomes, analyzed using statistical tests (Chi-square, Mann-Whitney, t-tests, ANOVA).

Main Results:

• Clinical response rates within 72 hours were similar between groups (42% piperacillin-tazobactam vs. 50% meropenem, P=0.31).
• Bacterial eradication rates at 72 hours were also comparable (54.16% piperacillin-tazobactam vs. 40.90% meropenem, P=0.67).

Conclusions:

• Empirical antibiotic choice between meropenem and piperacillin-tazobactam did not significantly alter clinical outcomes or bacterial eradication in critically ill sepsis patients.
• This suggests piperacillin-tazobactam can be considered as an alternative to carbapenems in specific antibiotic stewardship contexts.