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A Multicenter Study on Optimizing Piperacillin-Tazobactam Use: Lessons on Why Interventions Fail

Published online by Cambridge University Press:  02 January 2015

Robert P. Gaynes*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA Atlanta Veterans' Affairs Medical Center, Atlanta, GA
Carolyn V. Gould
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA
Jonathan Edwards
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA
Theresa L. Antoine
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA
Henry M. Blumberg
Affiliation:
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA Epidemiology Department, Grady Memorial Hospital, Atlanta, GA
Kathryn DeSilva
Affiliation:
Atlanta Veterans' Affairs Medical Center, Atlanta, GA
Mark King
Affiliation:
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA Epidemiology Department, Grady Memorial Hospital, Atlanta, GA
Alice Kraman
Affiliation:
Emory Crawford Long Hospital, Atlanta, GA
Jan Pack
Affiliation:
Emory University Hospital, Atlanta, GA
Bruce Ribner
Affiliation:
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA Emory University Hospital, Atlanta, GA
Ulrich Seybold
Affiliation:
Medizinische Poliklinik, Ludwig-Maximilians-University, Munich, Germany
James Steinberg
Affiliation:
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA Emory Crawford Long Hospital, Atlanta, GA
John A. Jernigan
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA
*
Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop A-24, Atlanta, GA 30333 (rgaynes@cdc.gov)

Abstract

We examined interventions to optimize piperacillin-tazobactam use at 4 hospitals. Interventions for rotating house staff did not affect use. We could target empiric therapy in only 35% of cases. Because prescribing practices seemed to be institution specific, interventions should address attitudes of local prescribers. Interventions should target empiric therapy and ordering of appropriate cultures.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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