Inpharma 1571 - 20 Jan 2007

Piperacillin/tazobactam: extendedinfusion "good alternative"

An extended-infusion dosing schedule for piperacillin/tazobactam therapy is a suitable alternative tointermittent infusion in the treatment of patients withPseudomonas aeruginosa infections, according to US-based researchers.

They retrospectively studied the medical records of194 patients who had initiated IV piperacillin/tazobactam 3.375g for the treatment of P. aeruginosainfection. Ninety-two patients had received a standard30-minute infusion every 4 or 6 hours, and 102 patientshad received an extended 4-hour infusion administeredevery 8 hours. Treatment was initiated within 72 hoursof infection onset and continued for a mean duration of8.4 days in both patient groups.

Among patients with an Acute Physiology and ChronicHealth Evaluation-II (APACHE II) score of ≥ 17, the14-day mortality rate was significantly lower for patientswho received extended infusion piperacillin/tazobactam, compared with those who receivedintermittent infusion (12.2% vs 31.6%); in addition, themedian duration of hospitalisation was significantlylower for patients in the extended infusion group (21 vs38 days). Among patients with an APACHE II score of< 17, no between group difference was noted for14-day mortality; however, a trend towards a shorterduration of hospitalisation was reported in patients whoreceived the extended infusion.

These data "strongly suggest that the clinical benefit isparticularly striking among critically ill patients with anAPACHE II score ≥17", conclude the authors.Lodise Jr TP, et al. Piperacillin-tazobactam for Pseudomonas aeruginosa infection:clinical implications of an extended-infusion dosing strategy. Clinical InfectiousDiseases 44: 357-363, No. 3, 1 Feb 2007 801058077

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Inpharma 20 Jan 2007 No. 15711173-8324/10/1571-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved