Journal Article

Clinical outcomes of extended versus intermittent administration of piperacillin/tazobactam for the treatment of hospital-acquired pneumonia: a randomized controlled trial

Lv, Y., Bao, H., Yan, Z., Wang, D., Xue, J.

2017

Overview

The purpose of this study was to assess the pharmacokinetic (PK) characteristics, clinical efficiency, and pharmacoeconomic parameters of piperacillin/tazobactam administered by extended infusion (EI) or intermittent infusion (II) in the treatment of hospital-acquired pneumonia (HAP) in critically ill patients with low illness severity in China. Fifty patients completed the study, with 25 patients receiving 4/0.5 g piperacillin/tazobactam over 30 min as the II group and 25 patients receiving 4/0.5 g piperacillin/tazobactam over 3 h every 6 h as the EI group. Drug assay was performed using high-performance liquid chromatography (HPLC). The percentage of the dosing interval for which the free piperacillin concentration (% f T) exceeds the minimum inhibitory concentration (MIC) was calculated. The patients’ therapy cost, clinical efficiency, and adverse effects were also recorded. % f T>MIC was about 100, 98.73, and 93.04 % in the EI arm versus 81.48, 53.29, and 42.15 % in the II arm, respectively, when the microorganism responsible for HAP had an MIC of 4, 8, and 16 mg/L. The therapy cost in the EI group was lower than that of the II group ($1351.72 ± 120.39 vs. $1782.04 ± 164.51, p  = 0.001). However, the clinical success rate, clinical failure rate, and drug-related adverse events did not significantly differ between groups. EI treatment with piperacillin/tazobactam was a cost-effective approach to the management of HAP, being equally clinically effective to conventional II.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adolescent / Adult / Aged / Aged, 80 and over / Anti-Bacterial Agents - administration & dosage / Anti-Bacterial Agents - economics / Anti-Bacterial Agents - pharmacokinetics / Anti-Bacterial Agents - pharmacology / beta-Lactamase Inhibitors - administration & dosage / beta-Lactamase Inhibitors - economics / beta-Lactamase Inhibitors - pharmacokinetics / beta-Lactamase Inhibitors - pharmacology / Biomedical and Life Sciences / Biomedicine / China / Chromatography, High Pressure Liquid / Clinical outcomes / Costs and Cost Analysis / Critical Illness / Cross Infection - drug therapy / Drug-Related Side Effects and Adverse Reactions / Female / Humans / Infusions, Intravenous - economics / Infusions, Intravenous - methods / Internal Medicine / Liquid chromatography / Male / Medical Microbiology / Microbial Sensitivity Tests / Middle Aged / Original / Original Article / Penicillanic Acid - administration & dosage / Penicillanic Acid - analogs & derivatives / Penicillanic Acid - economics / Penicillanic Acid - pharmacokinetics / Penicillanic Acid - pharmacology / Pharmacokinetics / Piperacillin - administration & dosage / Piperacillin - economics / Piperacillin - pharmacokinetics / Piperacillin - pharmacology / Plasma - chemistry / Pneumonia, Bacterial - drug therapy / Treatment Outcome / Young Adult