Clinical cure of ventilator-associated pneumonia treated with piperacillin/tazobactam administered by continuous or intermittent infusion.

Abstract

The standard mode of administration of piperacillin treatment is by intermittent infusion. However, continuous infusion may be advantageous as beta-lactam antibiotics exhibit time-dependent antibacterial activity. In previous studies, we found a higher rate of clinical cure of ventilator-associated pneumonia (VAP) by continuous infusion rather than intermittent infusion of meropenem and ceftazidime. Therefore, the objective of this historical cohort study was to establish the clinical efficacy of piperacillin/tazobactam (PIP/TAZ) administered by continuous and intermittent infusion in the treatment of VAP in patients without renal failure. Logistic regression analysis showed a higher probability of clinical cure of VAP by continuous compared with intermittent infusion when the microorganism responsible for VAP had a minimum inhibitory concentration (MIC) of 8 microg/mL [8/9 (88.9%) vs. 6/15 (40.0%); odds ratio (OR)=10.79, 95% confidence interval (CI) 1.01-588.24; P=0.049] or 16 microg/mL [7/8 (87.5%) vs. 1/6 (16.7%); OR=22.89, 95% CI 1.19-1880.78; P=0.03]. Thus, administration of PIP/TAZ by continuous infusion may be considered more effective than intermittent infusion for the treatment of VAP caused by Gram-negative bacteria when the MIC of the microorganism responsible for VAP is 8-16 microg/mL in patients without renal failure.

• Authors: Leonardo Lorente, Alejandro Jiménez, María M Martín, José Luis Iribarren, Juan José Jiménez, María L Mora
• Journal: International journal of antimicrobial agents (Int J Antimicrob Agents) Vol. 33 Issue 5 Pg. 464-8 (May 2009) ISSN: 1872-7913 [Electronic] Netherlands
• PMID: 19150225 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Piperacillin, Tazobactam Drug Combination
• Penicillanic Acid
• Piperacillin

Topics

• Aged
• Anti-Bacterial Agents (administration & dosage, pharmacology, therapeutic use)
• Bacteria (drug effects)
• Cohort Studies
• Female
• Humans
• Infusions, Intravenous
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Penicillanic Acid (administration & dosage, analogs & derivatives, pharmacology, therapeutic use)
• Piperacillin (administration & dosage, pharmacology, therapeutic use)
• Piperacillin, Tazobactam Drug Combination
• Pneumonia, Bacterial (drug therapy)
• Pneumonia, Ventilator-Associated (drug therapy)
• Treatment Outcome