Clinical use and microbial sensitivity of piperacillin-tazobactam: a two-year hospital-based review with insights from a developing country

Piperacillin-tazobactam is a widely used antibiotic with significant activity against a broad spectrum of bacterial pathogens, including those resistant to other treatments. Its utility, especially in nosocomial settings, has been well documented globally, but data from Palestine were previously lacking. This study sought to examine the prescribing trends, indications, dosage protocols, and clinical outcomes associated with the use of piperacillin-tazobactam at a prominent tertiary care hospital in a developing country. A retrospective descriptive study was performed on patients who were administered piperacillin-tazobactam at our institution from June 2021 to July 2023. Data on demographics, clinical characteristics, infection types, microbiological profiles, and antibiotic sensitivity were analysed via IBM SPSS version 21. The demographic and clinical profiles of 748 patients revealed a median age of 47 years. Males constituted 56.4% of the sample. The most prevalent comorbidities were hematological malignancies (45.7%) and cardiovascular diseases (33.0%). Piperacillin-tazobactam was predominantly used in oncology settings (58.2%), with neutropenic fever (35.6%) and pneumonia (23.2%) being the most common indications. The dosing regimen typically involved a median dose of 4.5 g administered four times daily, with 75.3% of patients receiving it as empiric therapy. Discharge was the most common outcome (91.2%). Notably, ESBL-producing Escherichia coli was the most isolated pathogen (13.7%). Sensitivity analysis revealed decreased sensitivity against Escherichia coli and Klebsiella pneumoniae, which accounted for 31.3% and 10.4%, respectively, of the 144 bacteria sensitive to piperacillin-tazobactam. While piperacillin–tazobactam remains clinically effective, evolving resistance patterns underscore the importance of stewardship programs informed by local epidemiology and prospective outcome studies.