Comparative in vitro evaluation of piperacillin/tazobactam in a tertiary care hospital.
Bacterial resistance is usually a serious problem in tertiary care hospitals. The aim of this in vitro study was to evaluate the beta-lactamase inhibitor combination piperacillin/tazobactam in a hospital environment with high bacterial resistance rates and compare it with other beta-lactam agents. Three hundred and sixty-two isolates from various clinical materials were studied during the period March-August 1996. Material for culture was collected from patients of all the wards of our hospital, with the majority being from the Intensive Care Unit (45%). Pathogenic Gram-positive and Gram-negative bacteria with high resistance rates and beta-lactamase production were studied (staphylococci, enterococci, Enterobacteriaceae, Pseudomonas). Significant bacterial resistance rates were identified for ceftazidime (50% for Klebsiellae, 60% for Enterobacter spp, 60% for Proteus spp, 33% for Pseudomonas spp, 75% for Acinetobacter spp) and ciprofloxacin (33% for both Klebsiellae and Enterobacter spp, 67% for Pseudomonas spp, 50% Acinetobacter spp). Fifty percent of Enterococcus isolates were resistance to ciprofloxacin but all of them were susceptible to piperacillin/tazobactam, amoxicillin/clavulanate and imipenem. The antibacterial activity of piperacillin/tazobactam (susceptibility rates 83 to 100% for Enterobacteriaceae, 83% for Pseudomonas spp and 75% for Acinetobacter spp) was higher than that of ceftazidime, piperacillin and ciprofloxacin. Imipenem, being mostly a reserve product, showed higher activity against Acinetobacter, Klebsiella and Enterobacter species.
Platsouka
E
E
Microbiology Department, Evangelismos Hospital, Athens, Greece.
Zissis
N P
NP
Constantoulaki
S
S
Paniara
O
O
D000658:Amoxicillin / Q000494:pharmacology; D002442:Ceftazidime / Q000494:pharmacology; D018550:Cephalosporin Resistance; D002511:Cephalosporins / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology; D019818:Clavulanic Acid / Q000494:pharmacology; D004791:Enzyme Inhibitors / Q000494:pharmacology; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification*; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D010397:Penicillanic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology*; D010878:Piperacillin / Q000494:pharmacology*; D000078142:Tazobactam
D002511:Cephalosporins; D004791:Enzyme Inhibitors; D010406:Penicillins; D019818:Clavulanic Acid; D002939:Ciprofloxacin; D000658:Amoxicillin; D010397:Penicillanic Acid; D002442:Ceftazidime; D000078142:Tazobactam; D010878:Piperacillin