In 2016, an explosion at a factory of the Chinese industrial giant Qilu Pharmaceutical resulted in suspension of operations.1 The factory was the sole global manufacturer of several active pharmaceutical ingredients (APIs) for piperacillin-tazobactam (Zosyn). APIs are the chemical building blocks used in making a diverse number of antimicrobial agents. The explosion exacerbated an existing shortage of this vital antibiotic agent that is widely used in hospitals around the world. Since December 2014, manufacturing issues at 2 of 8 suppliers of piperacillin-tazobactam and regulatory issues at another manufacturer, combined with increasing demand for the drug, had produced unprecedented shortages in the US. The worldwide situation led many domestic and overseas hospitals to ration piperacillin-tazobactam and to substitute cephalosporin and carbapenem agents.2 Some hospitals dealt with the shortage by limiting use of piperacillin-tazobactam to patients with severe sepsis and ventilator-associated pneumonia at the expense of the greater use of other normally restricted and rationed antibacterial drugs.