Evaluation of the use of piperacillin/tazobactam (Tazocin^®) at Hamad General Hospital, Qatar: are there unjustified prescriptions?

Figures & data

Table 1 Conditions for which Tazocin^® was prescribed empirically and appropriateness of prescription

Provisional diagnosis	Total (column)	Appropriate	Inappropriate	Total (row)
Community-acquired UTI	49 (8.0%)	13 (25.0)	36 (75.0)	49 (100.0)
Peritonitis	24 (4.0%)	0 (0.0)	24 (100.0)	24 (100.0)
Acute cholycystitis	12 (2.0%)	0 (0.0)	12 (100.0)	12 (100.0)
Aspiration pneumonia	49 (8.0%)	0 (0.0)	49 (100.0)	49 (100.0)
Community acquired pneumonia	43 (7.0%)	0 (0.0)	43 (100.0)	43 (100.0)
Febrile neutropenia	12 (2.0%)	12 (100.0)	0 (0.0)	12 (100.0)
Line related sepsis	55 (9.0%)	49 (89.0)	6 (11.0)	55 (100.0)
Nosocomial pneumonia	61 (10.0%)	61 (100.0)	0 (0.0)	61 (100.0)
Nosocomial UTI	12 (2.0%)	6 (50.0)	6 (50.0)	12 (100.0)
Peritonitis with CAPD	12 (2.0%)	0 (0.0)	12 (100.0)	12 (100.0)
SBP	12 (2.0%)	0 (0.0)	12 (100.0)	12 (100.0)
Sepsis	207 (34.0%)	207 (100.0)	0 (0.0)	207 (100.0)
Skin and soft tissue infection	31 (5.0%)	0 (0.0)	31 (100.0)	31 (100.0)
Others	31 (5.0%)	0 (0.0)	31 (100.0)	31 (100.0)
Total	610 (100.0%)	348 (57.0)	262 (43.0)	610 (100.0)

Abbreviations: UTI, urinary tract infection; CAPD, continuous ambulatory peritoneal dialysis; SBP, spontaneous bacterial peritonitis.

Table 2 Summary of Tazocin^® usage appropriateness

Data	Appropriate	Inappropriate
Initial use as empirical therapy in accordance with hospital’s guidelines	348/610 (57%)	262/610 (43%)
Switching to an alternative antibiotic with narrow spectrum after receipt of culture and susceptibility data	198/254 (78%)	56/254 (22%)
Dosing in accordance with the hospital’s guidelines	610 (100%)	0.0%
Dose adjustment in renal impairment	213/213 (100%)	0.0%
Discontinuation once culture data were negative	105/265 (40%)	160/265 (60%)
Discontinuation once culture data showed resistant organism	27/30 (90%)	3/30 (10%)

Table 3 Departments in which the drug was prescribed empirically

Ward	Total (column)	Appropriate	Inappropriate	Total (row)
CCU	31 (5.0%)	25 (80.4%)	6 (19.6%)	31 (100.0%)
Medical	341 (56.0%)	183 (53.6%)	158 (46.4)	341 (100.0%)
MICU	159 (26.0%)	116 (73.0%)	43 (27.0%)	159 (100.0%)
SICU	18 (3.0%)	6 (33.3%)	12 (66.7%)	18 (100.0%)
Surgical	43 (7.0%)	6 (14.0%)	37 (86.0%)	43 (100.0%)
TICU	18 (3.0%)	12 (66.7%)	6 (33.3%)	18 (100.0%)
Total	610 (100%)	248 (57.0%)	262 (43.0%)	100 (100.0%)

Abbreviations: CCU, coronary care unit; MICU, medical intensive care unit; SICU, surgical intensive care unit; TICU, trauma intensive care unit.