title: A multicenter study on optimizing piperacillin-tazobactam use: lessons on why interventions fail.
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.
authors.affiliation: Centers for Disease Control and Prevention, Emory University School of Medicine, Atlanta Veterans' Affairs Medical Center, GA, USA. rgaynes@cdc.gov
authors.forename: Robert P
authors.initials: RP
authors.lastname: Gaynes
authors.forename: Carolyn V
authors.initials: CV
authors.lastname: Gould
authors.forename: Jonathan
authors.initials: J
authors.lastname: Edwards
authors.forename: Theresa L
authors.initials: TL
authors.lastname: Antoine
authors.forename: Henry M
authors.initials: HM
authors.lastname: Blumberg
authors.forename: Kathryn
authors.initials: K
authors.lastname: Desilva
authors.forename: Mark
authors.initials: M
authors.lastname: King
authors.forename: Alice
authors.initials: A
authors.lastname: Kraman
authors.forename: Jan
authors.initials: J
authors.lastname: Pack
authors.forename: Bruce
authors.initials: B
authors.lastname: Ribner
authors.forename: Ulrich
authors.initials: U
authors.lastname: Seybold
authors.forename: James
authors.initials: J
authors.lastname: Steinberg
authors.forename: John A
authors.initials: JA
authors.lastname: Jernigan
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000706:statistics & numerical data; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006787:Hospitals, Veterans; D006801:Humans; D008826:Microbial Sensitivity Tests; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D010818:Practice Patterns, Physicians'
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin