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Efficacy and safety of intravenous sulbactam/ampicillin 3 g 4 times daily in Japanese adults with moderate to severe community-acquired pneumonia: a multicenter, open-label, uncontrolled study.

Abstract
Although sulbactam/ampicillin (SBT/ABPC) 3 g 4 times daily (QID) is widely used worldwide for patients with moderate to severe community-acquired pneumonia (CAP), the 3 g QID regimen was not available in Japan. In fact, there has been no evidence from a formal clinical study regarding the efficacy and safety of SBT/ABPC 3 g QID in these patients. We report the first results of a multicenter, unblinded, non-comparative, phase 3 study of SBT/ABPC 3 g QID in Japanese adults with moderate to severe CAP. Forty-seven subjects with moderate to severe CAP were enrolled and received SBT/ABPC 3 g QID intravenously for 3-14 days. The clinical responses assessed by the data review committee (DRC) were the primary endpoints. The secondary endpoints included the bacteriological responses assessed by the DRC. The clinical efficacy rate at the test of cure (TOC) was 94.6%. The bacterial eradication rate at TOC was 91.7%. Causative pathogens were isolated from sputum sample taken at baseline in 28 subjects (59.6%). Common causative pathogens included Streptococcus pneumoniae (14 strains), Haemophilus influenzae (9 strains), and Moraxella catarrhalis (8 strains). The clinical efficacy rate and the bacterial eradication rate at TOC of the common pathogens were, respectively, 92.3% and 90.0% in subjects with S. pneumoniae, 83.3% and 75.0% in subjects with H. influenzae, and 87.5% and 87.5% in subjects with M. catarrhalis. All treatment-related adverse events were mild or moderate in severity. SBT/ABPC 3 g QID was well tolerated and demonstrated excellent clinical and bacteriological responses. ClinicalTrials.gov Identifier: NCT01189487.
AuthorsShigeru Kohno, Kazuhiro Tateda, Hiroshige Mikamo, Jun-Ichi Kadota, Yoshihito Niki, Rio Itamura
JournalJournal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (J Infect Chemother) Vol. 21 Issue 3 Pg. 182-8 (Mar 2015) ISSN: 1437-7780 [Electronic] Netherlands
PMID25533886 (Publication Type: Clinical Trial, Phase III, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Chemical References
  • Anti-Bacterial Agents
  • sultamicillin
  • Ampicillin
  • Sulbactam
Topics
  • Adolescent
  • Adult
  • Aged
  • Ampicillin (adverse effects, therapeutic use)
  • Anti-Bacterial Agents (adverse effects, therapeutic use)
  • Bacteria (isolation & purification)
  • Community-Acquired Infections (drug therapy, microbiology)
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Pneumonia, Bacterial (drug therapy, microbiology)
  • Sputum (microbiology)
  • Sulbactam (adverse effects, therapeutic use)
  • Treatment Outcome
  • Young Adult

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