TITLE:
Physician Experience and Clinical Utilization Patterns of Shalbactam TZ (Ceftriaxone + Tazobactam): A Multicentre HPER Survey from the Democratic Republic of the Congo
AUTHORS:
Munzika François, Mukendi Kabengele Onesime, Maketama Soki Jeannisse, Kingola Nsunda, Minos Ndabahweje Minani, Homeré Kisimbi, Kashal Marc
KEYWORDS:
Shalbactam TZ, Ceftriaxone, Tazobactam, Empirical Therapy, Physician Experience, Antimicrobial Resistance, Democratic Republic of the Congo
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.16 No.4,
November
13,
2026
ABSTRACT: Background: Bacterial infections remain a major cause of morbidity in low- and middle-income countries, where delayed microbiological diagnosis often necessitates empirical antibiotic therapy. Shalbactam TZ (ceftriaxone + tazobactam) is a broad-spectrum β-lactam/β-lactamase inhibitor combination increasingly used in routine clinical practice. However, real-world evidence regarding physician prescribing patterns, clinical experience, and perceptions of its effectiveness and safety in the Democratic Republic of the Congo (DRC) remains limited. Objective: This paper aims to evaluate physician experience and clinical utilization patterns of Shalbactam TZ in the management of common bacterial infections in the Democratic Republic of the Congo. Methods: A multicentre, cross-sectional HPER (Healthcare Professional Experience Research) survey was conducted among 304 physicians practicing in the DRC. A structured questionnaire collected information on monthly caseload, first-line prescribing preference, empirical antibiotic use, treatment expectations, dosing practices, clinical response, physician satisfaction, adverse effects, resistance perception, and economic viability of Shalbactam TZ across community-acquired pneumonia (CAP), complicated typhoid fever, diabetic foot infections (DFI), bone and joint infections, and surgical prophylaxis. Data were analysed using descriptive statistics and expressed as frequencies and percentages. Results: Community-acquired pneumonia and complicated typhoid fever were among the most frequently managed conditions. Shalbactam TZ was most commonly preferred as first-line therapy for complicated typhoid fever (78%) and CAP (76%). Broad-spectrum antimicrobial activity was identified as the principal reason for prescribing the drug (51%). Most clinicians reported clinical improvement within 4 - 6 days, with overall good-to-excellent satisfaction ranging from 91% to 97% across different indications. Injection-site pain (61% - 67%) was the most frequently reported adverse effect across indications, while diarrhoea, rash, and headache occurred less commonly. The majority of physicians (76%) considered Shalbactam TZ economically viable, and resistance was perceived to be infrequent in routine clinical practice. Conclusion: The findings indicate that physicians widely perceive Shalbactam TZ as a favourable, well-tolerated, and economically viable empirical antibiotic option for the management of common bacterial infections in the DRC, based on reported clinical experience rather than independently verified outcomes. Further prospective studies incorporating microbiological and patient-level clinical outcomes are recommended to validate these real-world observations.