In vitro activity of moxifloxacin and piperacillin/sulbactam against pathogens of acute cholangitis

AIM：To analyze the in vitro activity of moxifloxacin and piperacillin/sulbactam against pathogens isolated from patients with acute cholangitis. METHODS： In this prospective study a total of 65 patients with acute cholangitis due to biliary stone obstruction （n = 7）, benign biliary stricture （n = 16）, and malignant biliary stricture （n = 42） were investigated with regard to spectrum of bacterial infection and antibiotic resistance. Pathogens were isolated from bile cultures in all study patients. In 22 febrile patients, blood cultures were also obtained. In vitro activity of moxifloxacin and piperacillin/ sulbactam was determined by agar diffusion. RESULTS： Thirty-one out of 65 patients had positive bile and/or blood cultures. In 31 patients, 63 isolates with 17 different species were identified. The predominant strains were Enterococcus species （26/63）, Ecoli （13/63） and Klebsiella species （8/63）. A comparable in vitro activity of moxifloxacin and piperacillin/sulbactam was observed for E.coli and Klebsiella species. In contrast, Enterococcus species had higher resistances towards moxifloxacin. Overall bacteria showed antibiotic resistances in vitro of 34.9% for piperacillin/sulbactam and 36.5% for moxifioxacin.CONCLUSION： Enterococcus species, E.co/i and Klebsiella species were the most common bacteria isolated from bile and/or blood from patients with acute cholangitis. Overall, a mixed infection with several species was observed, and bacteria showed a comparable in vitro activity for piperacillin/sulbactam and moxifloxacin.

Cefoperazone sodium/sulbactam sodium vs piperacillin sodium/tazobactam sodium for treatment of respiratory tract infection in elderly patients

BACKGROUND Respiratory tract infections in the elderly are difficult to cure and can easily recur,thereby posing a great threat to patient prognosis and quality of life.AIM To investigate the therapeutic effects of different antibiotics in elderly patients with respiratory tract infection.METHODS Seventy-four elderly patients with respiratory tract infection were randomly allocated to a study(n=37;treated with cefoperazone sodium/sulbactam sodium)or control(n=37;treated with piperacillin sodium/tazobactam sodium on the basis of routine symptomatic support)group.Both groups were treated for 7 d.Time to symptom relief(leukocyte recovery;body temperature recovery;cough and sputum disappearance;and rale disappearance time),treatment effect,and laboratory indexes[procalcitonin(PCT),C-reactive protein(CRP),white blood cell count(WBC),and neutrophil percentage(NE)]before and 7 d after treatment and the incidence of adverse reactions were assessed.RESULTS In the study group,the time to WBC normalization(6.79±2.09 d),time to body temperature normalization(4.15±1.08 d),time to disappearance of cough and sputum(6.19±1.56 d),and time to disappearance of rales(6.68±1.43 d)were shorter than those of the control group(8.89±2.32 d,5.81±1.33 d,8.77±2.11 d,and 8.69±2.12 d,respectively;P=0.000).Total effective rate was higher in the study group(94.59%vs 75.68%,P=0.022).Serum PCT(12.89±3.96μg/L),CRP(19.62±6.44 mg/L),WBC(20.61±6.38×10^(9)/L),and NE(86.14±7.21%)levels of the study group before treatment were similar to those of the control group(14.05±4.11μg/L,18.79±5.96 mg/L,21.21±5.59×10^(9)/L,and 84.39±6.95%,respectively)with no significant differences(P=0.220,0.567,0.668,and 0.291,respectively).After 7 d of treatment,serum PCT,CRP,WBC,and NE levels in the two groups were lower than those before treatment.Serum PCT(2.01±0.56μg/L),CRP(3.11±1.02 mg/L),WBC(5.10±1.83×10^(9)/L),and NE(56.35±7.17%)levels were lower in the study group than in the control group(3.29±0.64μg/L,5.67±1.23 mg/L,8.13±3.01×10^(9)/L,and 64.22±8.08%,respectively;P=0.000).There was no significant difference in the incidence of adverse reactions between the groups(7.50%vs 12.50%,P=0.708).CONCLUSION Piperacillin sodium/tazobactam sodium is superior to cefoperazone sodium/sulbactam sodium in the treatment of elderly patients with respiratory tract infection with a similar safety profile.

Effects of piperacillin synthesis on the infterfacial tensions and droplet sizes

Piperacillin is a polar organic substance,and can reduce the interfacial tension of oil and water when dissolved in water.In this study,changes in dichloromethane–water interfacial tensions and microdroplet sizes during piperacillin synthesis from an aqueous solution of ampicillin and dichloromethane solution of 4-ethyl-2,3-dioxo-1-piperazine carbonyl chloride(EDPC)were observed using a pendent drop technique and a coaxial ring tube system with embedded high-speed camera,respectively.It was found that the rapid N-acylation reaction caused the piperacillin at the interface to synthesize rapidly and diffuse out slowly,resulting in the interfacial tension decreased from 19.5 m N·m-1 to 7.2 m N·m-1 rapidly and then increased slowly as the concentrations of ampicillin and EDPC were 0.05 mol·L-1 and 0.1 mol·L-1.Meanwhile,the increase in the concentration of EDPC increased the peak concentration of piperacillin at the interface,and the addition of ethyl acetate to the ampicillin solution promoted mass transfer and reduced the aggregation of piperacillin effectively.During synthesis,the interfacial tension decreased,leading to a change in droplet sizes in the micro-reaction system.The two-phase reaction was carried out in a coaxial ring tube,with ampicillin and EDPC solutions as continuous and dispersed phases,respectively.The reaction reduced the dripping flow area,and the addition of ethyl acetate to the ampicillin solution slightly affected the division of the flow pattern.Under the same flow conditions,the droplet sizes of the reaction group were smaller than those of the no reaction group.The experimental results demonstrated that the increase of the continuous phase,decrease in the dispersed phase flow rate,or increase in EDPC concentration making droplet sizes smaller,and the addition of ethyl acetate slightly affected droplet sizes.These findings are important for the design and optimization of piperacillin synthesis reactors.

Historical Cohort Study of the Efficacy and Safety of Piperacillin/Tazobactam Versus Fourth-Generation Cephalosporins for Empirical Treatment of Febrile Neutropenia in Patients with Hematological Malignancies

We retrospectively evaluated the efficacy and safety of the combination drug piperacillin/tazobactam (PIPC/TAZ) in comparison with those of fourth-generation cephalosporins (4th Cephs) as initial empirical treatment in hematological malignancies patients with febrile neutropenia (FN). Among 200 patients assessed in this study, 49 had received PIPC/TAZ and 151 4th Cephs. Patient background characteristics were comparable between the two treatment groups. The overall efficacy rate in those receiving 4th Cephs and PIPC/TAZ was 57.0% (86/151 patients) and 59.2% (29/49 patients), respectively, with no significant difference detected between the two treatment regimens (P = 0.78). Treat-ment did not need to be discontinued or interrupted due to development of adverse drug reactions in any of the patients. Therefore in this study the efficacy and safety of PIPC/TAZ as initial antimicrobial treatment for FN in patients with hematological malignancies were not inferior to those of 4th Cephs. Based on the preliminary data obtained in this study, we propose to conduct a multicenter, prospective, controlled study to compare PIPC/TAZ versus CFPM given as empirical antimicrobial treatment against FN in patients with hematological malignancies.

Piperacillin enhances the inhibitory effect of tazobactam on β-lactamase through inhibition of organic anion transporter 1/3 in rats

To assess the mechanism of the pharmacokinetic interaction between piperacillin and tazobactam,renal excretion and pharmacokinetic studies of piperacillin/tazobactam were investigated in normal and bacteremia rats.A bacteremia model was established to investigate the pharmacokinetic properties of piperacillin and tazobactam under different conditions.Renal slices were taken to examine the uptake of piperacillin and tazobactam.Pharmacokinetic studies ofβ-lactamase in rats were performed to study the contribution of rOat1/3 to the inhibition of tazobactam onβ-lactamase.The AUC(from 2.93±0.58 to 6.52±1.44 mg·min/ml)and the plasma clearance(CL P)(from 2.41±1.20 to 0.961±0.212 ml/min/kg)of tazobactam were both altered after the intravenous coadministration of piperacillin and tazobactam in the bacteremia rats.The renal clearance(CL R)of tazobactam decreased from 1.30±0.50 to 0.361±0.043 ml/min/kg.In summary,there was a beneficial interaction between piperacillin and tazobactam mediated by rOat1 and rOat3.Piperacillin enhances the inhibitory effect of tazobactam onβ-lactamase through the inhibition of rOat1 and rOat3 in rats.The contribution rate of rOat1/3 for the synergistic effect was 20%when the two drugs were coadministered.

Empirical antibiotic treatment with piperacillin-tazobactam in Patients with microbiologically-documented biliary tract infections

AIM: To report our experience with empiric antimicrobial monotherapy (piperacillin/tazobactam, of which no data are available in such specific circumstances) in microbiologically-documented infections in patients with benign and malignant conditions of the biliary tract.METHODS: Twenty-three patients, 10 with benign and 13 with malignant conditions affecting the biliary tree and microbiologically-documented infections were recruited and the efficacy of empirical antibiotic therapy was assessed.RESULTS: The two groups featured similar demographic and clinical data. Overall, the infective episodes were most due to Gram negative agents, more than 60% of such episodes (mostly in malignant conditions) were preceded by invasive instrumental maneuvers. Empirical antibiotic therapy with a single agent (piperacillin/tazobactam) was effective in more than 80% of cases. No deaths were reported following infections. CONCLUSION: An empiric therapeutic approach with piperacillin/tazobactam is highly effective in biliary tract infections due to benign or malignant conditions.

Assessment of Susceptibility, Pharmacodynamics, and Therapeutic Response for Interpretation of Piperacillin-Tazobactam <i>in Vitro</i>Activity in the Treatment of <i>Pseudomonas aeruginosa</i>Infection

Pseudomonas aeruginosa remains an important pathogen. Our purpose was to determine the minimum inhibitory con-centration (MIC) and pharmacodynamic (PD) parameters predicting a positive response to therapy with piperacil-lin-tazobactam. Medical records were retrospectively reviewed at 3 centers. Data were recorded to assess age, type of disease, renal function, weight (body mass), MIC, antimicrobial treatment, and clinical outcome. Success was response to piperacillin-tazobactam alone, or in combination with another active agent;failure was lack of response. Of 78 eva-luable patients, 63 responded (7 UTI;56 non-UTI) and 15 did not;26 responding received combination therapy and 37 monotherapy. Piperacillin-tazobactam treatment was successful in 53 of 63 of non-UTI disease with a MIC of ≤64/4 μg/mL, but in only 3 of 7 with a MIC of >64/4 μg/mL (P = 0.023);overall 9 of 10 infections by strains with MICs = 32 - 64 μg/mL had a successful outcome. Piperacillin estimated time above MIC at 20% separated those responding from those that did not (P = 0.019).

Retrospective Evaluation of Acute Kidney Injury： Extended Infusion versus Standard Infusion Piperacillin/Tazobactam with Vancomycin

Antibiotics cause 36 percent of all cases of drug-induced AKI （acute kidney injury）. Research suggests that drug-induced AKI increases hospital length of stay, ventilator days and mortality. The purpose of this study was to determine which administration method of piperacillin/tazobactam （pip/tazo） would have a higher incidence of AKI in combination with vancomycin. All patients greater than 18 years old admitted to the general medical floor, who were receiving combination therapy were included in the study. Excluded patients comprised： patients with a baseline SCr （serum creatinine） greater than 2 mg/dL, receiving peritoneal dialysis or hemodialysis, an ICU stay, pregnancy, and concomitant use of defined nephrotoxic agents. AKI was defined as an absolute increase in SCr of 0.5 mg/dL or a 50% increase from baseline. The primary outcome of AKI occurred in 18 out of 63 patients （28.6%） in the standard-infusion pip/tazo plus vancomycin group and 9 out of 35 patients （25.7%） in the extended-infusion pip/tazo plus vancomycin group （Z = -0.30, p-value = 0.381）. AKI is very prevalent with one of our most frequently used empiric antibiotic combinations. While this study found no significant difference, as pharmacists, we learned it is still necessary to closely monitor patients＇ receiving this antibiotic combination.

A Liquid Chromatography Assay for the Simultaneous Quantification of Piperacillin and Ciprofloxacin in Human Plasma and Dialysate in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy

Piperacillin/tazobactam and ciprofloxacin are often used in combination as initial empiric anti-biotic therapy in critical ill patients. Especially in patients undergoing continuous renal replacement therapy (CRRT) the pharmacokinetics of antimicrobial agents can be highly variable. In order to avoid under- or overdosage of antibiotics therapeutic drug monitoring (TDM) is highly re-commendable. Based on two known HPLC assays for piperacillin a new method in combination with solid phase extraction (SPE) for the simultaneous determination of piperacillin and ciprofloxacin was developed. Method validation was performed according to the EMA guideline on validation of bioanalytical methods. The HPLC column used was a Perfect Bond ODS-HD C18 analytical column (100 mm × 4.6 mm i.d., particle size 5 μm), equipped with a guard column (10 mm × 4.6 mm, particle size 5 μm) containing the same packing material. Detection wavelength was set at 228 nm for piperacillin and benzylpenicillin was used as internal standard (IS). Ciprofloxacin was determined at two wavelengths (280 nm, 315 nm). This newly developed HPLC method in combination with SPE-extraction allows an accurate, precise, specific and efficient determination of piperacillin and ciprofloxacin in biological matrices. Results allow the calculation of all relevant pharmacokinetic data for critically ill patients undergoing CRRT and the optimization of dosing and TDM.

Tazobactam/Piperacillin复剂的儿科药代动力学和临床疗效

本文概述了Tazobactam/Piperacillin复剂儿科领域药代动力学和临床应用研究。

Dose optimization of piperacillin/tazobactam in patients with renal dysfunction based on population pharmacokinetic and pharmacodynamic simulations

In the present study, we aimed to investigate the optimal dosage regimens of piperacillin/tazobactam in patients with chronic kidney disease according to their different classes of renal function based on bacterial resistance. A total of 2700 simulationswere applied based on a published population pharmacokinetic and pharmacodynamic model using nonlinear mixed effects modeling (NONMEM) software. Permissible optimal dosage regimens were defined as those associated with a less than 10% of patients whose probabilities of target attainment (PTA) were not attain target. For patients with mild to moderate renal injury, 4/0.5 g of piperacillin/tazobactam every 12 h in 30 min intermittent infusion could attain the target. If the MIC (minimum inhibitory concentration) for the pathogen was 8 mg/L or 16 mg/L, either an 8-h or 6-h dosing interval or extended 2–6 h infusion regimen had to be used to achieve the outcome of the therapy. Regarding MIC was up to above 32 mg/L, a high dose of piperacillin (12–24 g/d) in continuous infusion was the only approach that could achieve the effective target in patients with renal dysfunction. A low dose with extended 4–6 h infusion regimen was recommended for patients with severe renal injury. Our study identified permissible optimal piperacillin/tazobactam dosage regimens for patients with renal dysfunction with an MIC up to 64 mg/L. The findings of this study would be helpful for precise administration of piperacillin/tazobactam in clinical practice.

Impact of extended-infusion piperacillin-tazobactam in a Canadian community hospital

Background:Studies have demonstrated improved clinical outcomes with extended infusion(EI)piperacillin/tazobactam(TZP)compared to standard infusion(SI).However,there is less evidence on its benefits in noncritically-ill patients.Hospital-wide EI TZP was implemented at our site on February 21,2012.Our objectives were to compare clinical,safety and economic outcomes between EI and SI TZP.Methods:A retrospective cohort study of all adult patients who received EI TZP(3.375 g IV q8h infused over 4 hours and SI TZP for≥48 hours during 3 years pre-and postimplementation was conducted.The primary study outcome was 14-day mortality while secondary outcomes included length of hospital stay(LOS),nursing plus pharmacy cost,occurrence of Clostridioides difficile infection,readmission within 30 days and change in Pseudomonas aeruginosa minimum inhibitory concentration(MIC)distribution for TZP.The primary outcome and binary secondary outcomes were analyzed using a logistic regression model.LOS was examined using time to event analysis.Cost was examined using linear regression modelling.Results:Overall,2034 patients received EI TZP and 1364 patients received SI TZP.EI TZP was associated with lower odds of mortality(OR 0.76,95%CI 0.63-0.91),lower odds of C.difficile infection(OR 0.59,95%CI 0.41-0.84)and 8%lower cost(estimate 0.92,95%CI 0.87-0.98)compared to SI TZP.Conclusions:Hospital-wide implementation of EI TZP was associated with lower odds of 14-day mortality and incidence of C.difficile infection with cost savings at our institution.

不同配比哌拉西林钠他唑巴坦钠在重症肺炎治疗中的安全性及影响因素研究

目的:探讨不同配比哌拉西林钠他唑巴坦钠在重症肺炎患者治疗中的安全性及其影响因素。方法:回顾性调查2021年8月至2022年8月中国医科大学附属第一医院应用不同配比哌拉西林钠他唑巴坦钠治疗的重症肺炎患者的不良反应(粒细胞缺乏、血小板计数降低、过敏和腹泻)发生情况。根据治疗方案(复方制剂相关配比)分为治疗1组[采用哌拉西林钠他唑巴坦钠(4∶1)治疗]和治疗2组[采用哌拉西林钠他唑巴坦钠(8∶1)治疗]。统计分析患者年龄、性别、既往疾病、用药剂量、用药疗程等与各不良反应相关性。结果:治疗1组患者的总不良反应发生率为79.61%(609/765),低于治疗2组(84.55%,476/563),差异有统计学意义(P<0.05)。单因素Logistic回归分析结果显示,哌拉西林钠他唑巴坦钠(8∶1)的复方制剂配比(OR=1.098,P=0.012)、住院时间延长(OR=1.029,P<0.001)是不良反应发生的独立危险因素(P<0.05);多因素Logistic回归分析结果显示,年龄增长(OR=1.012,P=0.011)、用药疗程延长(OR=1.036,P=0.013)是总不良反应发生的影响因素。结论:哌拉西林钠他唑巴坦钠(4∶1)治疗重症肺炎具有更高的安全性。较长的用药疗程和住院时间可能增加应用哌拉西林钠他唑巴坦钠治疗患者的不良反应发生风险。

哌拉西林-他唑巴坦对急性心肌梗死经皮冠状动脉介入治疗术后医院感染者炎性因子的影响

目的 探究哌拉西林-他唑巴坦对急性心肌梗死经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后医院感染患者炎性因子及心肌酶谱的影响。方法 以80例急性心肌梗死PCI术后医院感染患者作为研究对象,随机分为对照组和观察组,每组40例。对照组给予头孢呋辛,观察组给予哌拉西林-他唑巴坦。比较2组的临床疗效、炎性因子[超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)和白细胞介素-6(interleukin-6,IL-6)]、左心室重构[左心室舒张末期内径(left ventricular end-systolic diameter, LVESD)、收缩末期内径(left ventricular end-diastolic diameter, LVEDD)和左心室射血分数(left ventricular ejection fraction, LVEF)]、心肌酶谱指标[肌钙蛋白Ⅰ(cardiac troponin Ⅰ,cTnⅠ)、肌酸激酶同工酶(creatine kinase-MB, CK-MB)和肌酸脱氢酶(lactate dehydrogenase, LDH)]和不良反应。结果 治疗后,与对照组比较,观察组的总有效率明显较高(P<0.05);观察组的hs-CRP、MMP-9和IL-6均明显较低(P<0.05),LVESD、LVEDD均明显较低(P<0.05), LVEF明显较高(P<0.05), cTnⅠ、CK-MB和LDH均明显较低(P<0.05);2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 哌拉西林-他唑巴坦对急性心肌梗死PCI术后医院感染患者具有较好的临床疗效,可下调炎性因子,减轻左心室重构,降低心肌酶谱指标水平,且安全性高。

基于FAERS的哌拉西林他唑巴坦不良事件信号挖掘与分析

目的挖掘哌拉西林他唑巴坦(TZP)的药品不良事件(ADE)信号,促进临床合理、安全用药。方法采用比例失衡法对美国食品药品管理局不良事件报告系统(FAERS)自建库至2024年3月所有TZP ADE报告进行信号挖掘,分析报告病例的基本情况及不良反应相关信息。结果共提取得到主要怀疑药物涉及ADE报告数为20620513条,TZP为主要怀疑药物涉及ADE报告数为6489条。共挖掘ADE信号543个,涉及25个器官/系统分类(SOC),二次筛选最终检测出ADE信号数43个,其中新的ADE信号17个,ADE信号涉及SOC分类的数量排名前5为分别是皮肤及皮下组织类疾病、全身性疾病及给药部位各种反应、各类检查、感染及侵染类疾病、血液及淋巴系统疾病;ADE信号数排名前5位的首选术语分别为皮疹、发热、急性肾损伤、瘙痒、血小板减少症。青霉素类药物在血液及淋巴系统疾病存在多种不良反应信号,TZP导致血小板减少病例数最多,苯唑西林导致粒细胞缺乏关联强度比例报告比值比最高;TZP导致白细胞减少疗程中位数为11.00 d,累积剂量中位数为148.50 g;该药导致粒细胞缺乏疗程中位数为14.00 d,累积剂量中位数为216.00 g;该药导致血小板减少症疗程中位数为7.00d,累积剂量中位数为87.00 g。结论用药期间需密切关注皮肤及皮下组织类疾病相关不良反应,可能较胃肠道系统疾病更多;临床大剂量或长疗程应用TZP时可导致多个系统发生不良反应,尤其需密切关注血液及淋巴系统疾病相关不良反应,避免发生严重不良反应。

哌拉西林他唑巴坦诱发溶血性贫血的文献病例分析

目的分析哌拉西林他唑巴坦诱发溶血性贫血的发生情况和特点,为临床安全用药提供参考。方法计算机检索PubMed、Web of Science、CNKI、WanFang Data和VIP数据库,搜集有关哌拉西林他唑巴坦诱发溶血性贫血的病例报道,检索时限均从建库至2023年12月,并对患者的基本信息、药物的使用情况、溶血性贫血及其并发症和转归等进行统计分析。结果共纳入25篇文献27个病例,其中男14例(51.85%),女13例(48.15%),年龄4 d~77岁,首次发生溶血性贫血的时间<24h~18d不等。25例明确了发生溶血性贫血时的最低血红蛋白水平,介于27~113 g·L^(-1),其中14例为重度、极重度贫血(<60 g·L^(-1))。经停药、更换抗菌药物和对症支持治疗后,25例(92.59%)患者的溶血性贫血改善或恢复,其中1例停用哌拉西林他唑巴坦后贫血有所改善,但停药后15 d患者因多器官衰竭死亡;另外2例贫血未见好转,最终自动出院或临床死亡。结论溶血性贫血是哌拉西林他唑巴坦罕见的不良反应,症状无明显特异性,临床使用应监测血红蛋白水平,发现异常且若明确哌拉西林他唑巴坦为可疑药物应及时停药,必要时需采取输注红细胞等措施。

哌拉西林与头孢他啶对小儿肺炎的疗效差异研究

目的本文主要探究哌拉西林和头孢他啶对小儿肺炎的临床疗效的差异。方法选择2021年5月—2022年5月在院治疗的80例小儿肺炎的患者,依据治疗方法分为头孢他啶组、哌拉西林组,每组40例。头孢他啶组除常规治疗外给予头孢他啶抗感染,哌拉西林组除常规治疗外给予哌拉西林抗感染。比较两组小儿肺炎患者的治疗效果、症状消失时间、不良反应。结果哌拉西林组治疗效果优于头孢他啶组,哌拉西林组症状消失时间比头孢他啶组短,哌拉西林组不良反应比头孢他啶组少,两组治疗效果、症状消失时间、不良反应的比较差异有统计学意义(P<0.05)。结论哌拉西林是治疗小儿肺炎较为有效的方法,具有治疗效果好、不良反应少的优点,值得临床推广。

两种抗感染药物治疗重症肺炎的效果及炎症因子水平预后比较

目的:探究哌拉西林钠他唑巴坦与亚胺培南西司他丁钠治疗重症肺炎的效果及对炎症因子水平、预后的影响。方法:选取2020年1月至2023年3月我院收治的105例重症肺炎患者,用随机数字表法分为A组(n=53)和B组(n=52),A组用亚胺培南西司他丁钠治疗,B组用哌拉西林钠他唑巴坦钠治疗。比较两组患者临床症状消失时间(咳嗽、肺阴影、肺啰音、体温恢复时间),比较治疗前和治疗7d后,两组患者严重程度[肺部感染量表(CPIS)、急性生理学及慢性健康状况(APACHEⅡ)、Murray肺损伤量表(MLIS)]、血气指标[氧饱和度(SpO_(2))、血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]及炎症因子[白细胞总数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)]水平,统计不良反应发生情况。结果:B组咳嗽、肺阴影、肺啰音消失时间及体温恢复时间均短于A组(P均<0.05);治疗7d后,两组患者CPIS、APACHEⅡ、MLIS评分、PaCO_(2)、炎症因子(WBC、CRP、PCT)水平均显著降低,B组水平变化大于A组(P均<0.05);部分血气指标(SpO_(2)、PaO_(2))水平显著升高,B组水平变化大于A组(P均<0.05);两组患者不良反应发生率无显著性差异(P>0.05)。结论:哌拉西林钠他唑巴坦钠与亚胺培南西司他丁钠均可减轻重症肺炎患者病情及临床症状,改善血气状况,缓解炎症反应,但哌拉西林钠他唑巴坦钠效果更佳。

哌拉西林他唑巴坦钠与头孢哌酮舒巴坦钠治疗老年重症肺炎的疗效研究

目的:探究哌拉西林他唑巴坦钠(PIP-TAZ)与头孢哌酮舒巴坦钠(CPZ-SBT)治疗老年重症肺炎(SP)的疗效与安全性。方法:纳入150例老年SP患者做为研究对象,所有患者均接受常规治疗及阿米卡星治疗,根据治疗药物不同将患者分为哌拉西林组和头孢哌酮组,每组各75例。哌拉西林组给予PIP-TAZ治疗;头孢哌酮组给予CPZ-SBT治疗。比较两组患者临床疗效,治疗前及治疗后两组患者血气指标、炎症因子水平、肺功能及不良反应发生情况。结果:哌拉西林组发热、咳嗽、肺啰音消失时间及痰液颜色改变时间均短于头孢哌酮组(P<0.05);治疗后,两组患者血氧分压(PaO_(2))、pH值水平均升高(P<0.05),二氧化碳分压(PaCO_(2))水平均降低(P<0.05),但两组间PaO_(2)、pH值、PaCO_(2)水平差异均无统计学意义(P>0.05);治疗后,两组患者降钙素原(PCT)、白细胞计数(WBC)、C反应蛋白(CRP)水平均降低(P<0.05),且哌拉西林组低于头孢哌酮组(P<0.05);治疗后,两组患者最高呼气流速(PEF)、用力肺活量(FVC)、第1秒最大呼吸容积(FEV1)水平均升高(P<0.05),且哌拉西林组高于头孢哌酮组(P<0.05)。两组患者不良反应发生率无统计学差异(P>0.05)。结论:PIP-TAZ与CPZ-SBT均可有效治疗老年SP,但PIP-TAZ可有效缩短症状改善时间,缓解炎症反应及肺损伤效果更佳,且安全性较高。