Comparison of Piperacillin/Tazobactam Dosing (13.5 g/day vs. 18 g/day) for the Treatment of Hospital-Acquired Pneumonia and Ventilator-associated Pneumonia in Intensive Care Unit.
10.24304/kjcp.2018.28.3.167
- Author:
Jeung Yun KANG
1
;
Kyung A LEE
;
Jae Song KIM
;
Soo Hyun KIM
;
Eun Sun SON
Author Information
1. Department of Pharmacy, Severance Hospital, Yon-sei University Health System, Seoul 03722, Republic of Korea. sespharm@yuhs.ac
- Publication Type:Original Article
- Keywords:
Pneumonia;
piperacillin;
tazobactam drug combination;
treatment outcomes;
safety
- MeSH:
Adult;
Aged;
Americas;
Blood Cell Count;
Communicable Diseases;
Critical Care*;
Electronic Health Records;
Hospitals, General;
Humans;
Intensive Care Units*;
Piperacillin;
Platelet Count;
Pneumonia*;
Pneumonia, Ventilator-Associated*;
Reference Values;
Retrospective Studies
- From:Korean Journal of Clinical Pharmacy
2018;28(3):167-173
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In July 2016, the Infectious diseases society of america and the american thoracic society (IDSA & ATS) published a guideline recommending piperacillin/tazobactam (Pip/Tazo) 18 g/day as the anti-pseudomonal dose for the treatment of pathogenic pneumonia. After the guideline was published, the Pip/Tazo dose used for the treatment of pathogenic pneumonia was changed from 13.5 g/day to 18 g/day in a superior general hospital intensive care unit (ICU). In this study, we analyzed the effectiveness and safety of the new dose. METHODS: Adult patients aged ≥19 years who were diagnosed with pneumonia in ICU and who received Pip/Tazo for 7 days or more from September 1, 2015 to May 31, 2017 were included in the study. The electronic medical record (EMR) was retrospectively analyzed. RESULTS: At baseline, there was a significant difference between 44 patients treated with 13.5 g/day and 31 patients treated with 18 g/day of Pip/Tazo. The 18 g/day-treatment group comprised more elderly patients than the 13.5 g/day-treatment group (p=0.028). The results of the treatment-effects analysis showed no significant difference between the two groups. In case of safety data, there were significant differences in two parameters related to blood count, namely hemoglobin (p=0.016) and platelet count (p=0.011). CONCLUSION: Based on the significant difference in baseline age, there is a possibility that high-dose Pip/Tazo showed improved therapeutic effect. However, when high-dose Pip/Tazo was used, the blood cell count was found to drop from the reference value more frequently. Therefore, blood cell count should be monitored carefully when high-dose Pip/Tazo is administered.
