Continuous versus intermittent piperacillin/tazobactam infusion in infection due to or suspected pseudomonas aeruginosa

• Published in: International journal of clinical pharmacy 2016-02, Vol.38 (1), p.70-79
• Main Authors: Cotrina-Luque, Jesús, Gil-Navarro, Maria Victoria, Acosta-García, Héctor, Alfaro-Lara, Eva Rocío, Luque-Márquez, Rafael, Beltrán-García, Margarita, Bautista-Paloma, Francisco Javier
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; Bacterial Load; Cross Infection - diagnosis; Cross Infection - drug therapy; Cross Infection - microbiology; Double-Blind Method; Drug Administration Schedule; Drug therapy; Female; Humans; Infections; Infusions, Intravenous; Internal Medicine; Intravenous therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Penicillanic Acid - administration & dosage; Penicillanic Acid - adverse effects; Penicillanic Acid - analogs & derivatives; Pharmacy; Piperacillin - administration & dosage; Piperacillin - adverse effects; Pseudomonas aeruginosa; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - growth & development; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - diagnosis; Pseudomonas Infections - drug therapy; Pseudomonas Infections - microbiology; Remission Induction; Research Article; Side effects; Spain; Time Factors; Treatment Outcome; Young Adult
• ISSN: 2210-7703; 2210-7711
• DOI: 10.1007/s11096-015-0208-y

Background There is lack of information on the efficacy and safety of piperacillin–tazobactam administered by continuous infusion. Objective The aim of this study was to investigate whether continuous infusion of piperacillin–tazobactam is superior in terms of efficacy to a 30 % higher dose administered by intermittent infusion to treat suspected or confirmed infection due to Pseudomonas aeruginosa . Setting Multicenter clinical trial with 11 third level Spanish hospitals. Method Randomized, double-blind parallel-group clinical trial, controlled by conventional administration of the drug. Patients randomly assigned in a 1:1 ratio to receive piperacillin–tazobactam as continuous infusion (CI) or intermittent (II). Main outcome measure Primary efficacy endpoint was percentage of patients having a satisfactory clinical response at completion of treatment, defined as clinical cure or clinical improvement. Adverse events were reported. Results 78 patients were included, 40 in the CI group and 38 in the II group. Mean (standard deviation) duration of treatment was 7 (±4.44) days. 58 patients (74.4 %) experienced cure or improvement at the end of the treatment. There were no statistical differences in cure rates between the two treatment arms and no adverse events were reported. Conclusion Continuous infusion of piperacillin–tazobactam is an alternative administration drug method at least similar in efficacy and safety to conventional intermittent infusion. Multivariate analysis is needed to determine whether continuous administration might be more beneficial than intermittent in certain patient subgroups.