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Implementation of an extended-infusion piperacillin-tazobactam program at an urban teaching hospital.

Author(s): Xamplas RC, Itokazu GS, Glowacki RC, Grasso AE, Caquelin C, Schwartz DN

Affiliation(s): Department of Pharmacy, John H. Stroger Jr. Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612, USA. rxamplas@uicalumni.org

Publication date & source: 2010-04-15, Am J Health Syst Pharm., 67(8):622-8.

PURPOSE: The development and implementation of an extended-infusion piperacillin-tazobactam program at an urban teaching hospital are described. SUMMARY: A multidisciplinary team was formed to address the feasibility of converting from the standard 30-minute infusion to an extended infusion of piperacillin- tazobactam. Before hospitalwide implementation, feasibility studies were performed in a subset of patients to identify potential barriers to program implementation. On the day of hospitalwide conversion, the orderables for piperacillin-tazobactam were reprogrammed in the computerized prescriber-order-entry system to allow separate options for the 30-minute infusion (for pediatric patients) and the extended-infusion regimen. After selecting the orderable for the extended-infusion regimen, an electronic message appeared to remind prescribers of the rationale for this change and recommended indications for piperacillin-tazobactam. Program success was prospectively evaluated on 11 weekdays after hospitalwide conversion for all 96 adult inpatients receiving piperacillin-tazobactam. Of the 194 piperacillin-tazobactam doses observed, 90% were appropriate, with compliance increasing to 100% by the end of the observation period. There was near-complete cessation of the every-6-hour dosage interval and a marked increase in the every-8-hour and every-12-hour dosage intervals. The number of piperacillin-tazobactam doses per 1000 patient-days significantly decreased during the postimplementation period. During the postimplementation period, pharmacy expenditures related to piperacillin-tazobactam decreased by 18% and the total number of grams of piperacillin-tazobactam purchased decreased by 24%. CONCLUSION: A hospitalwide program for the administration of extended-infusion piperacillin-tazobactam was safely and successfully implemented using a multi-disciplinary approach in an urban teaching hospital.

Page last updated: 2010-10-05

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