• A retrospective cohort study at the University of Michigan examined hospital admissions from July 1, 2014, to December 31, 2018, including a piperacillin-tazobactam shortage from June 12, 2015, to September 18, 2016.

• The study focused on adult sepsis patients treated with a combination of vancomycin and piperacillin-tazobactam, or cefepime.

• Primary and secondary outcomes included the following:

1. 90-day mortality

2. Organ failure-free days

3. Ventilator-free days 

4. Vasopressor-free days

• The study involved 7,569 patients, with 4,523 receiving vancomycin and piperacillin-tazobactam and 3,046 receiving vancomycin and cefepime.

• Analysis showed no significant differences in patient demographics or initial health status between the groups.

• However, piperacillin-tazobactam was linked to a 5.0% absolute increase in 90-day mortality and fewer days free of organ failure, ventilator use, and vasopressor use.

• The findings suggest that for patients with suspected sepsis and no apparent need for anti-anaerobic coverage, piperacillin-tazobactam is associated with higher mortality and longer organ dysfunction compared to cefepime.

• This raises concerns about the broad use of empirical anti-anaerobic antibiotics in sepsis treatment.

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