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Piperacillin/Tazobactam Use vs Cefepime May Be Associated With Acute Decompensated Heart Failure

Hans R Scheerenberger1, Susan Kullab1,2, Ahmed Elgazzar2

  • 1James H. Quillen Veterans Affairs Medical Center, Mountain Home, Tennessee.

Federal Practitioner : for the Health Care Professionals of the VA, Dod, and PHS
|June 5, 2024
PubMed
Abstract

Insights

Piperacillin/tazobactam (PTZ) use is linked to increased heart failure (HF) exacerbations and readmissions compared to cefepime. Caution is advised when prescribing PTZ to patients with a history of HF.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Pharmacology

Background:

  • Piperacillin/tazobactam (PTZ) use is often limited in heart disease patients due to high sodium content and concerns for heart failure (HF) exacerbation.
  • No previous studies have definitively established a link between PTZ and HF exacerbation.

Purpose of the Study:

  • To investigate the association between Piperacillin/tazobactam (PTZ) use and acute decompensation of heart failure (HF).
  • To compare the incidence of HF exacerbation and readmission between PTZ and cefepime in hospitalized veterans.

Main Methods:

  • A retrospective review of 389 hospitalized veterans over two years (2018-2019).
  • Comparison of PTZ use versus cefepime in relation to acute decompensation of HF.
  • Analysis of HF readmissions, length of stay, and mortality.

Main Results:

  • Acute decompensation of HF was significantly higher in patients receiving PTZ (12.3%) compared to cefepime (2.2%) (P < .001).
  • Hospital readmissions due to HF exacerbation were also higher with PTZ use (11 vs 1).
  • No significant differences were observed in length of stay or overall mortality between the two antibiotic groups.

Conclusions:

  • Piperacillin/tazobactam use is significantly associated with increased incidence of acute decompensation and hospital readmission for HF exacerbation compared to cefepime.
  • Careful monitoring or avoidance of PTZ is recommended for hospitalized patients with a history of HF.

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