by In the high-pressure environment of emergency rooms and intensive care units, healthcare professionals make quick decisions on which antibiotics to administer when facing life-threatening infections, such as sepsis. A recent study published in the Journal of the American Medical Association (JAMA) Internal Medicine sheds light on the potential unintended consequences of these choices.
The study, conducted by researchers at the University of Michigan, took advantage of a 15-month national shortage of piperacillin/tazobactam, a commonly used antibiotic for sepsis treatment, to compare the outcomes of hospitalized patients with sepsis who received either piperacillin/tazobactam or cefepime. The latter antibiotic, while having similar activity against common sepsis pathogens, has minimal effects on anaerobic gut bacteria.
Piperacillin/tazobactam is a broad-spectrum antibiotic that is frequently used for sepsis treatment. During the shortage, clinicians often resorted to using cefepime as an alternative. Robert Dickson, M.D., of the University of Michigan’s Department of Medicine’s Division of Pulmonary & Critical Care Medicine and Deputy Director of the Weil Institute for Critical Care Research & Innovation, explained, “We saw this Zosyn shortage as a unique opportunity to investigate whether this antibiotic, which we know depletes the gut of anaerobic bacteria, has an impact on patient outcomes.”
In a healthy individual, the gut microbiome is predominantly populated by anaerobic bacteria, which rarely cause disease but play essential roles in the body’s metabolism, immunity, and prevention of infections. Previous research by the study team has shown that a single dose of piperacillin/tazobactam kills most of these anaerobic gut bacteria. The study aimed to determine if this antibiotic’s impact on the gut microbiome could influence patient outcomes.
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