title: Piperacillin/tazobactam compared with ticarcillin/clavulanate in community-acquired bacterial lower respiratory tract infection.
abstract: The efficacy and safety of a new combination parenteral antibiotic, piperacillin/tazobactam, was compared with that of parenteral ticarcillin/clavulanate in the treatment of adult patients with community-acquired lower respiratory tract infections. A total of 299 patients were enrolled in this multicentre, double-blind, comparative study; 177 received piperacillin/tazobactam and 122 received ticarcillin/clavulanate. Of these, 119 met the evaluability criteria (69, piperacillin/tazobactam and 50, ticarcillin/clavulanate). The study drugs (piperacillin/tazobactam 3 g/375 mg or ticarcillin/clavulanate 3 g/100 mg) were given every 6 h by slow iv infusion for a minimum of 5 days. The favourable clinical response (cured and improved) rates of evaluable patients were 84% and 64% at endpoint (P < 0.01) for piperacillin/tazobactam and ticarcillin/clavulanate, respectively. The favourable bacteriological response at the early follow-up (eradicated and presumed eradicated) were 91% and 67% for piperacillin/tazobactam and ticarcillin/clavulanate, respectively (P < 0.01). At endpoint, 84% and 64%, respectively (P = 0.02) had a favourable response. The most common adverse experiences involved the gastrointestinal tract and occurred in 31.6% of the piperacillin/tazobactam group compared with 20.5% in the ticarcillin/clavulanate group (P = 0.02). These events were mild and generally did not affect therapy. Piperacillin/tazobactam appears to be more effective than ticarcillin/clavulanate in this patient population and is generally well tolerated.
authors.affiliation: Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: D M
authors.initials: DM
authors.lastname: Shlaes
authors.forename: R
authors.initials: R
authors.lastname: Baughman
authors.forename: C T
authors.initials: CT
authors.lastname: Boylen
authors.forename: J C
authors.initials: JC
authors.lastname: Chan
authors.forename: N B
authors.initials: NB
authors.lastname: Charan
authors.forename: Y C
authors.initials: YC
authors.lastname: Cormier
authors.forename: A
authors.initials: A
authors.lastname: Erickson
authors.forename: R
authors.initials: R
authors.lastname: Grossman
authors.forename: N
authors.initials: N
authors.lastname: Kirmani
authors.forename: B
authors.initials: B
authors.lastname: Suh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000187:drug effects; D002969:Clavulanic Acids / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000382:microbiology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010397:Penicillanic Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D010878:Piperacillin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D000078142:Tazobactam; D013982:Ticarcillin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D065093:beta-Lactamase Inhibitors
chemical_list: D002969:Clavulanic Acids; D065093:beta-Lactamase Inhibitors; C043215:ticarcillin-clavulanic acid; D010397:Penicillanic Acid; D013982:Ticarcillin; D000078142:Tazobactam; D010878:Piperacillin