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Comment & Response
August 26, 2024

Reevaluating Piperacillin-Tazobactam Mortality

Author Affiliations
  • 1Department of Internal Medicine, Min Sheng General Hospital, Taoyuan, Taiwan
  • 2Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • 3Graduate Institute of Toxicology and Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan
JAMA Intern Med. 2024;184(10):1268. doi:10.1001/jamainternmed.2024.4117

To the Editor With keen interest, we read the retrospective cohort study by Chanderraj et al,1 which investigated the mortality influences posed by different classes of broad-spectrum antibiotics among patients with suspected sepsis, based on data collected during a period of specific antibiotic shortage. Their findings indicated that the use of piperacillin-tazobactam was associated with a significant increase in 90-day mortality and a decrease in organ failure–free days compared to cefepime. They suggested that the extended anaerobic coverage provided by piperacillin-tazobactam might be responsible for these outcomes. We agree that this is an important factor; however, we propose that other pharmacokinetic and pharmacodynamic issues related to piperacillin-tazobactam may also contribute to its adverse outcomes.

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