Korean J Clin Pharm.  2018 Sep;28(3):167-173. 10.24304/kjcp.2018.28.3.167.

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

• Kang JY
• Lee KA
• Kim JS
• Kim SH
• Son ES

• KMID: 2438541
• DOI: http://doi.org/10.24304/kjcp.2018.28.3.167

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.

Keyword

Pneumonia; piperacillin; tazobactam drug combination; treatment outcomes; safety

MeSH Terms

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
Piperacillin