title: Randomized, open-label, comparative study of piperacillin-tazobactam administered by continuous infusion versus intermittent infusion for treatment of hospitalized patients with complicated intra-abdominal infection.
abstract: The purpose of this randomized, multicenter, open-label study was to compare the continuous infusion of piperacillin-tazobactam with the standard intermittent infusion in 262 hospitalized patients with complicated intra-abdominal infections. Within 1 day of surgical intervention, eligible patients were randomized (1:1) to piperacillin-tazobactam 12 g/1.5 g administered continuously over 24 h or 3 g/0.375 g administered over 30 min intermittently every 6 h for 4 to 14 days. The demographics of the patients in the groups were similar, with a median APACHE II score of 7 and a median length of hospitalization of 7 days. Among 167 clinically evaluable patients, 86.4% and 88.4% of the patients treated with the continuous infusion and the intermittent infusion, respectively, were clinically cured or improved at the test-of-cure visit (P = 0.817). Bacteriological success was observed in 83.9% and 87.9% of patients (P = 0.597) in the two groups, respectively, and no differences in bacteriological response by pathogen were noted. Defervesence and white blood cell count normalization occurred in the majority of patients within 3 days and were similar between patients receiving the continuous infusion and those receiving the intermittent infusion. Drug-related adverse events were generally mild and were reported in similar numbers of patients in each arm of the trial. The results of this study support continuous infusion as a safe and reasonable alternate mode of administration of piperacillin-tazobactam for the treatment of complicated intra-abdominal infection.
authors.affiliation: The Queens Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813, USA. laue002@hawaii.rr.com
authors.forename: William K
authors.initials: WK
authors.lastname: Lau
authors.forename: David
authors.initials: D
authors.lastname: Mercer
authors.forename: Kamal M
authors.initials: KM
authors.lastname: Itani
authors.forename: David P
authors.initials: DP
authors.lastname: Nicolau
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Kuti
authors.forename: Debra
authors.initials: D
authors.lastname: Mansfield
authors.forename: Adrian
authors.initials: A
authors.lastname: Dana
mesh_terms: D018806:APACHE; D000005:Abdomen / Q000382:microbiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D004311:Double-Blind Method; D004338:Drug Combinations; D004791:Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010406:Penicillins / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D000078142:Tazobactam
chemical_list: D004338:Drug Combinations; D004791:Enzyme Inhibitors; D010406:Penicillins; D010397:Penicillanic Acid; D000078142:Tazobactam