John Allen, BCCCP, BCPS, PharmD (he/him/his)
Associate Dean & Clinical Associate Professor
University of Florida College of Pharmacy
Orlando, Florida
Disclosure information not submitted.
Carinda Feild, PharmD, FCCM
Clinical Associate Professor
University of Florida
Saint Petersburg, Florida, United States
Disclosure information not submitted.
Bethany Shoulders, BCCCP, BS, PharmD
Clinical Assistant Professor
University of Florida Health
Gainesville, Florida
Disclosure information not submitted.
Stacy Voils, BCPS, MS, PharmD
Clinical Associate Professor
University of Florida, United States
Disclosure information not submitted.
Title: Evaluation of Black-white racial disparities in sepsis patients treated with piperacillin-tazobactam
Introduction: Racial disparities have been described in several disease states, with previous evidence noting that the widest disparities are observed between Black and White patients. Black patients have a higher incidence of conditions that require ICU-level care, including sepsis. Reasons for disparities are likely multifactorial and include individual, community, policy, and hospital-related factors. In sepsis patients, early administration of antibiotics has been associated with improved outcomes. Among these, piperacillin-tazobactam is frequently used due to its broad-spectrum of activity. This study aimed to evaluate the presence of racial disparities in sepsis patients treated with piperacillin-tazobactam.
Methods: This study is a subgroup analysis of data previously collected from a retrospective, observational study in adult critically ill patients with sepsis treated with piperacillin-tazobactam. All adult sepsis inpatients whose race was categorized as Black or White, admitted from 1/2012- 12/2018, and received P-T for 48 hours were considered for study inclusion. The primary outcome was 28-day norepinephrine-free days (NFD). Secondary outcomes included 28-day hospital-free days (HFD), in-hospital mortality/hospice disposition, and Anti-Pseudomonal escalation (APE) rate.
Results: 1183 patients met inclusion criteria (Black: n=257, 21.7%; White: n=926, 78.3%). Median baseline Charlson Comorbidity Index (Black: 4 [IQR: 2-7]; White: 4 [IQR: 2-6]), and minimum Rothman Index (Black: 22.3 [IQR:6.2 -43.6]; White: 24.8 [IQR: 8.6- 45.6]) were similar between the two groups. Median 28-day NFD (Black: 25.8 [IQR: 0- 27]; White: 25.4 [IQR:0- 27]), hospital-free days (Black: 0 [IQR:0-14]; White: 0 [IQR: 0-14]), in-hospital mortality/hospice disposition (Black: 32.2%; White: 35.3%), APE rate (Black: 23.7%; White: 20.8%). The median time to APE (Black: 6.4 [IQR: 2.9- 9.3]; White: 5.2 [IQR: 2.5-8.7] days).
Conclusion: In our retrospective study, Black-white racial disparities were not observed.