title: Continuous infusion of piperacillin/tazobactam in septic critically ill patients--a multicenter propensity matched analysis.
abstract: The clinical efficacy of continuous infusion of piperacillin/tazobactam in critically ill patients with microbiologically documented infections is currently unknown. We conducted a retrospective multicenter cohort study in 7 Portuguese intensive care units (ICU). We included 569 critically ill adult patients with a documented infection and treated with piperacillin/tazobactam admitted to one of the participating ICU between 2006 and 2010. We successfully matched 173 pairs of patients according to whether they received continuous or conventional intermittent dosing of piperacillin/tazobactam, using a propensity score to adjust for confounding variables. The majority of patients received 16g/day of piperacillin plus 2g/day of tazobactam. The 28-day mortality rate was 28.3% in both groups (p = 1.0). The ICU and in-hospital mortality were also similar either in those receiving continuous infusion or intermittent dosing (23.7% vs. 20.2%, p = 0.512 and 41.6% vs. 40.5%, p = 0.913, respectively). In the subgroup of patients with a Simplified Acute Physiology Score (SAPS) II>42, the 28-day mortality rate was lower in the continuous infusion group (31.4% vs. 35.2%) although not reaching significance (p = 0.66). We concluded that the clinical efficacy of piperacillin/tazobactam in this heterogeneous group of critically ill patients infected with susceptible bacteria was independent of its mode of administration, either continuous infusion or intermittent dosing.
authors.affiliation: Unidade de Cuidados Intensivos Polivalente, Hospital São Francisco Xavier Hospital, CHLO, Lisboa, Portugal. joaogpster@gmail.com
authors.forename: João
authors.initials: J
authors.lastname: Gonçalves-Pereira
authors.forename: Bruno Serra
authors.initials: BS
authors.lastname: Oliveira
authors.forename: Sérgio
authors.initials: S
authors.lastname: Janeiro
authors.forename: Joana
authors.initials: J
authors.lastname: Estilita
authors.forename: Catarina
authors.initials: C
authors.lastname: Monteiro
authors.forename: Andrea
authors.initials: A
authors.lastname: Salgueiro
authors.forename: Alfredo
authors.initials: A
authors.lastname: Vieira
authors.forename: Joao
authors.initials: J
authors.lastname: Gouveia
authors.forename: Carolina
authors.initials: C
authors.lastname: Paulino
authors.forename: Luis
authors.initials: L
authors.lastname: Bento
authors.forename: Pedro
authors.initials: P
authors.lastname: Póvoa
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D007239:Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality / Q000473:pathology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D010878:Piperacillin / Q000008:administration & dosage; D000077725:Piperacillin, Tazobactam Drug Combination; D011174:Portugal
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin