Tazobactam/piperacillin for moderate-to-severe pneumonia in patients with risk
for aspiration: comparison with imipenem/cilastatin.
Author(s): Ito I, Kadowaki S, Tanabe N, Haruna A, Kase M, Yasutomo Y, Tsukino M, Nakai A,
Matsumoto H, Niimi A, Chin K, Ichiyama S, Mishima M.
Affiliation(s): Department of Respiratory Medicine, Kyoto University Hospital, Sakyo, Kyoto,
Japan. isaoito@kuhp.kyoto-u.ac.jp
Publication date & source: 2010, Pulm Pharmacol Ther. , 23(5):403-10
BACKGROUND: Treatment of aspiration pneumonia is becoming an important issue due
to aging of populations worldwide. Effectiveness of tazobactam/piperacillin
(TAZ/PIPC) in aspiration pneumonia is not clear.
PURPOSE: To compare clinical efficacy between TAZ/PIPC (1:4 compound) and
imipenem/cilastatin (IPM/CS) in patients with moderate-to-severe aspiration
pneumonia.
PATIENTS AND METHODS: In this open-label, randomized study either TAZ/PIPC 5 g or
IPM/CS 1 g was intravenously administered every 12 h to patients with
moderate-to-severe community-acquired aspiration pneumonia or nursing
home-acquired pneumonia with risk for aspiration pneumonia for average 11 days.
The primary outcome was clinical response rate at the end of treatment (EOT) in
validated per-protocol (VPP) population. Secondary outcomes were clinical
response during treatment (days 4 and 7) and at the end of study (EOS) in VPP
population, and survival at day 30 in modified intention-to-treat (MITT)
population.
RESULTS: There was no difference between the groups in primary or secondary
outcome. However, significantly faster improvement as measured by axillary
temperature (p < 0.05) and WBC count (p = 0.01) was observed under TAZ/PIPC
treatment. In patients with gram-positive bacterial infection, TAZ/PIPC was more
effective at EOT in VPP population (p = 0.03).
CONCLUSION: TAZ/PIPC is as effective and safe as IPM/CS in the treatment of
moderate- to-severe aspiration pneumonia.
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