Comparison of Piperacillin/Tazobactam and Imipenem/Cilastatin, both in Combination with Tobramycin, Administered Every 6h for Treatment of Nosocomial PneumoniaRespiratory Medicine
AbstractThis randomized, double-blind, multicenter study compared the efficacy and safety of piperacillin/tazobactam (P/T) and imipenem/cilastatin (IMP), both in combination with an aminoglycoside, in hospitalized patients with acute nosocomial pneumonia (NP). Patients with acute NP, defined as pneumonia with symptoms ⩾48 h after admission or ⩽7 days after hospital discharge, received infusions of 4 g/500 mg P/T or 500 mg/500 mg IMP every 6 h. Endpoints were clinical cure and microbiological response rates; pathogen eradication rates; length of hospital stay; hospital readmissions; and adverse events (AEs). Of 437 patients in the intent-to-treat population, 197 were efficacy evaluable. At test-of-cure, response rates were similar between groups. Within the efficacy evaluable population, 68% of P/T patients and 61% of IMP patients were clinically cured (P=0.256P=0.256). Microbiological responses for P/T and IMP patients were: eradication, 64% versus 59%; persistence, 29% versus 21%; relapse, 0% versus 5%; and superinfection, 7% versus 15%, respectively. Gram-positive isolates were eradicated in 83% of P/T patients and 75% of IMP patients; Gram-negative pathogens were eradicated in 72% of P/T patients and 77% of IMP patients. Treatment groups had similar number of mean hospital days, readmission rates, and frequency of AEs. This study showed that P/T administered four times per day was as safe and efficacious as IMP in treating hospitalized patients with NP.
Citation InformationManjari Joshi, Michael Metzler, Mary C. McCarthy, Stephen Olvey, et al.. "Comparison of Piperacillin/Tazobactam and Imipenem/Cilastatin, both in Combination with Tobramycin, Administered Every 6h for Treatment of Nosocomial Pneumonia" Respiratory Medicine Vol. 100 Iss. 9 (2006) p. 1554 - 1565 ISSN: 0954-6111
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