Evaluation of the Achievement of a Pharmacodynamic Target of Piperacillin-Tazobactam for the Population With Obesity: An Open Randomized Controlled Feasibility Study (TAZO-OBESITY Trial).
Sabrina Larocque, Juliette Fournier, Justine Brasseur-Masse et al.
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In 30 seconds
The open-label randomized feasibility trial TAZO-OBESITY compared standard with prolonged piperacillin-tazobactam infusions in patients with obesity (BMI ≥30 kg/m²). It assessed recruitment, protocol adherence, safety, and, exploratorily, attainment of 100% free drug concentration above the minimum inhibitory concentration (fT > MIC) at 24 hours. Forty-five patients were recruited, meeting recruitment feasibility objectives, although blood-sampling adherence was below target. Target attainment was 64.3% with prolonged infusion versus 55.6% with standard infusion (p = 0.725); safety outcomes did not differ significantly (p = 0.756).
Key findings
- Forty-five patients were recruited at 7.2 patients per month, with a consent rate of 42.1%, meeting recruitment feasibility objectives.
- Blood-sampling adherence was 77.8%, below the prespecified 80% objective.
- At 24 hours, 100% fT > MIC attainment was 64.3% with prolonged infusion and 55.6% with standard infusion (p = 0.725).
- Safety outcomes did not differ significantly between groups (p = 0.756).
Why it matters
Achieving adequate antibiotic exposure is a pharmacodynamic consideration in patients with obesity. This trial provides preliminary randomized evidence on infusion strategy and shows that a larger study is feasible, while its exploratory target-attainment results are not statistically significant. The findings help define the evidence gap without establishing that prolonged infusion improves clinical outcomes.
What to keep in mind
This was a feasibility study with 45 participants; blood-sampling adherence fell short of the 80% objective. Target attainment was exploratory, and the abstract reports no clinical efficacy outcome.