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Common antibiotic that can be a killer

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A common antibiotic that is routinely used in hospitals can sometimes be a killer.

Zosyn (piperacillin/tazobactam) is usually given to patients with sepsis, a life-threatening autoimmune response to infection—but researchers have found that it raises the chances of death and organ failure by 5 percent.

Doctors discovered its dangers only when supplies of the antibiotic ran short and they instead turned to another drug, cefepime, that is kinder to the gut.  Zosyn depletes the gut of anaerobic bacteria, and this can influence how—and if—the patient recovers; even just one dose dramatically alters the gut microbiome.

Researchers at the University of Michigan studied the records of 7,569 patients, 4,523 of whom were given Zosyn, and the rest had cefepime.  There was a 5 percent increase in deaths, organ failure, and days on a ventilator among the Zosyn group.

Zosyn may be just too powerful and threatens the life of the patient as much as the pathogen it’s trying to eliminate.  “These are powerful antibiotics that are administered to patients every day in every hospital.  Clinicians use them because they are trying to treat every possible pathogen that might be causing the illness,” said Rishi Chanderraj, one of the researchers.

Earlier studies hadn’t seen any difference in mortality levels between the two antibiotics over 14 days, but the new study extended the time they tracked patients and discovered that deaths occurred within 90 days.

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JAMA Internal Med, 2024; doi: 10.1001/jamainternmed.2024.0581Food for the
Article Topics: antibiotics, sepsis
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