Efficacy and tolerability of piperacillin/tazobactam versus ceftazidime in association with amikacin for treating nosocomial pneumonia in intensive care patients: a prospective randomized multicenter trial

Abstract

Amikacin associated with either ceftazidime or piperacillin and tazobactam has shown comparable efficacy and tolerability in the treatment of ICU patients with nosocomial pneumonia.

Piperacillin/Tazobactam vs Imipenem/Cilastatin in the Treatment of Nosocomial Pneumonia—a Double Blind Prospective Multicentre Study

“…Nosocomial pneumonia requires prompt treatment and often before the causative organisms are identified [1,5,8,9]. Identification in mechanically ventilated patients is hampered by the poor sensitivity and specificity of diagnostic methods [3,10] and delaying therapy until the pathogens are identified may well be too late to influence survival [9]. Most episodes of inadequate empiric treatment are associated with Pseudomonas aeruginosa, Acinetobacter species, and Staphylococcus aureus, usually methicillin-resistant strains [5,11] and the presence of P. aeruginosa, can lead to fatality rates of more than 40% [12].…”

“…Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae and staphylococci (excluding methicillin-resistant strains) are highly susceptible to piperacillin/tazobactam [14,15]. Some resistance is observed in P. aeruginosa, Klebsiella, Acinetobacter, Enterobacter, Citrobacter and Serratia species [5,10,11] and this is usually as a result of limited inhibition by tazobactam of the inducible chromosomally mediated Class 1 cephalosporinase produced by these organisms [15][16][17]. The fixed combination of piperacillin/tazobactam (dose ratio 8:1) has proved effective in the treatment of moderate to severe polymicrobial nosocomial infections, and has demonstrated equivalent or better efficacy than standard comparator regimens in these infections [14,16,[18][19][20][21][22].…”

The Efficacy of Intravitreal Piperacillin/Tazobactam in Rabbits with Experimental <i>Staphylococcus epidermidis</i> Endophthalmitis: A Comparison with Vancomycin

“…The activity degree of piperacillin/tazobactam is about 32-fold superior to amoxicillin/clavulanic acid against some clinical isolates of extended-spectrum enteric bacilli that produce ␤ -lactamase (MIC 90 , 2 g/ml) [29] . It was reported to have equivalent or better effi cacy than amoxicillin/clavulanic acid or 'third-generation' cephalosporins [30] . Examples of the key piperacillin/tazobactam MIC 90 and percent susceptibilities were: oxacillin-susceptible S. aureus (2 g/ml; 100.0%), oxacillin-susceptible coagulase-negative staphylococci (0.5 g/ml; 100.0%), vancomycin-susceptible enterococci ( 1 128 g/ml; 85.7%), ␤ -hemolytic streptococci (0.25 g/ml; 100.0%), viridans group streptococci (8 g/ml; 100.0% at ^ 16 g/ml), penicillin-resistant Streptococcus pneumoniae (4 g/ml; 100.0% at ^ 8 g/ml), Haemophilus infl uenzae ( ^ 0.06 g/ml; 100.0% susceptible) and Pseudomonas aeruginosa (3 g/ ml; 96.0%) [31,32] .…”

Determination of Nontoxic Concentrations of Piperacillin/Tazobactam for Intravitreal Application

“…Although piperacillin/tazobactam is currently used with high success against most serious infections [ [14][15][16][17][18][30][31][32][33], there are no clinical trials using piperacillin/tazobactam in the treatment of endophthalmitis. In addition, intravitreal safe dose of piperacillin/tazobactam combination has not been studied yet.…”

“…Piperacillin/tazobactam is currently indicated for use in appendicitis, peritonitis, complicated or uncomplicated infections of the skin, postpartum endometritis, pelvic inflammatory disease, and bacterial lower respiratory tract infection. Results of trials evaluating the efficacy of piperacillin/tazobactam in the treatment of these infections are very promising with cure rates ranging from 61 to 100% [14][15][16][17][18].…”