Pharmacist-Led Empiric Piperacillin-Tazobactam De-escalation Among Patients With Community-Acquired Intra-abdominal...

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Pharmacy

Background:

• Piperacillin-Tazobactam (PTZ) is frequently used for community-acquired intra-abdominal infections (CA-IAIs).
• Declining susceptibility to PTZ among common pathogens necessitates strategies like antibiotic de-escalation.
• De-escalation to narrow-spectrum agents prevents resistance to broad-spectrum antibiotics like PTZ.

Purpose of the Study:

• To evaluate the impact of a pharmacist-led intervention on PTZ therapy duration in CA-IAI patients.
• To compare outcomes between patients receiving PTZ de-escalation and those who did not.

Main Methods:

• Retrospective analysis of CA-IAI patients treated with PTZ.
• Comparison of pre-intervention (2022) and post-intervention (2024) groups.
• Assessment of PTZ utilization, length of stay (LOS), and complications using regression models.

Main Results:

• The intervention group showed a significant reduction in PTZ therapy duration (mean 1.2 days shorter).
• No significant differences were observed in LOS, 30-day readmission, treatment complications, C. difficile, or medication toxicity.
• P-values indicate statistical significance for reduced PTZ duration (P < 0.001).

Conclusions:

• Pharmacist-led de-escalation of PTZ for CA-IAI effectively shortens antibiotic course.
• This strategy is safe and does not lead to negative clinical outcomes.
• Antibiotic stewardship is crucial for managing CA-IAI and preventing resistance.