Piperacillin/tazobactam associated hypernatremia impacts on SARS-COV-2 infected patients
1 Clinical Pharmacy Specialist, King Hussein Medical Center, Royal Medical Services, Amman, Jordan.
2 Logistic Pharmacy Specialist, King Hussein Medical Center, Royal Medical Services, Amman, Jordan.
3 Internal Medicine/Intensivist, King Hussein Medical Center, Royal Medical Services, Amman, Jordan.
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2023, 14(03), 288–299.
Article DOI: 10.30574/wjbphs.2023.14.3.0261
Publication history:
Received on 03 May 2023; revised on 19 June 2023; accepted on 22 June 2023
Abstract:
Objectives: The consequences of antibiotics-associated non-nutritional hypernatraemia may have a positive clinical impact on the mitigation of the COVID-19 related hyponatremia complications. This study aimed to explore the positive utility of Piperacillin/Tazobactam-associated sodium loading in COVID-19 patients.
Methods: A retrospective study was conducted between Mar 2020 and Sep 2021. Eligible patients were stratified into two antibiotics-based cohorts; Non-Tazocin Cohort and Tazocin Cohort. One-Sample and Independent T-Tests and Chi-Square Test were conducted and the corrected sodium and its changes from baseline were run into the Receiver Operating Characteristics Tests followed by Sensitivity analysis.
Results: The incidence of hyponatremia was significantly higher in Cohort I compared to Cohort II [378 (100.0%) vs 248 (61.5%), respectively, p-value=0.00]. The corrected sodium concentration was significantly lower in Cohort I compared to Cohort II [134.85±4.59 mEq/l vs 137.19±4.93 mEq/l, -2.34±0.34 mEq/l, p-value=0.00]. The mortality risk estimate for our institutional COVID-19 on PIP/TAZ vs Non-PIP/TAZ was 0.98 (95% CI; 0.74-1.29). 1.215 (95% CI; 0.85-1.73).
Conclusion: Piperacillin/Tazobactam antibiotics administration in SARS-CoV-2 infected patients may have a non-antibiotic mortality benefit via its clinically significant propensity to mitigate the risk of hyponatremia-related negative clinical consequences, including mortality. This study investigated that it was optimally to keep averaged sodium concentrations above 133.85 mEq/l and to restrict dropping in sodium concentration by more than 1.95% from baseline.
Keywords:
Piperacillin/Tazobactam; β-lactam antibiotics; Carbapenems; Antibiotic-associated hypernatremia; Severe COVID-19 infected patients
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