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 piperac...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).展开更多
Objective To study the difference between piperacillin-tazobactam and other anti infective agents in the treatment of blood stream infection caused by extended spectrum beta-lactamase(ESBL)-producing Enterobacteriacea...Objective To study the difference between piperacillin-tazobactam and other anti infective agents in the treatment of blood stream infection caused by extended spectrum beta-lactamase(ESBL)-producing Enterobacteriaceae by systematic review and meta-analysis.Meth-ods PubMed,Cochrane library,Web of Science,CNKI,Weipu DATA,and CPVIP were systematically searched.Literatures were reviewed and data regarding mortality of mono-drug treatment with different antibiotics were collected.All data were pooled using the technique of metaanalysis by Revman 5.3,and heterogeneity tests were performed.Results Eleven articles containing 1620 patients were included.Escherichia coli and Klebsiella pneumonia were the main pathogens,and there were 31 cases caused by Enterobacter cloacae.There was no statistically significant difference in mortality between carbapenems and piperacillin-tazobactam mono-therapy for the empirical treatment(RR=0.86;95% CI:0.62-1.20,P>0.05)or for definitive treatment(RR=0.63;95% CI:0.20-1.97,P>0.05).Carbapenems were used as the main antibiotics for definitive treatment as well as empirical treatment.Conclusion Piperacillintazobactam treatment is not associated with increased mortality of the patients with ESBL-positive enterobacteria bloodstream infection,which can be used as an alternative antibiotics.展开更多
文摘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).
文摘Objective To study the difference between piperacillin-tazobactam and other anti infective agents in the treatment of blood stream infection caused by extended spectrum beta-lactamase(ESBL)-producing Enterobacteriaceae by systematic review and meta-analysis.Meth-ods PubMed,Cochrane library,Web of Science,CNKI,Weipu DATA,and CPVIP were systematically searched.Literatures were reviewed and data regarding mortality of mono-drug treatment with different antibiotics were collected.All data were pooled using the technique of metaanalysis by Revman 5.3,and heterogeneity tests were performed.Results Eleven articles containing 1620 patients were included.Escherichia coli and Klebsiella pneumonia were the main pathogens,and there were 31 cases caused by Enterobacter cloacae.There was no statistically significant difference in mortality between carbapenems and piperacillin-tazobactam mono-therapy for the empirical treatment(RR=0.86;95% CI:0.62-1.20,P>0.05)or for definitive treatment(RR=0.63;95% CI:0.20-1.97,P>0.05).Carbapenems were used as the main antibiotics for definitive treatment as well as empirical treatment.Conclusion Piperacillintazobactam treatment is not associated with increased mortality of the patients with ESBL-positive enterobacteria bloodstream infection,which can be used as an alternative antibiotics.
