TY - JOUR
T1 - Comparison of piperacillin/tazobactam and imipenem/cilastatin, both in combination with tobramycin, administered every 6 h for treatment of nosocomial pneumonia
AU - Joshi, Manjari
AU - Metzler, Michael
AU - McCarthy, Mary
AU - Olvey, Stephen
AU - Kassira, Wedad
AU - Cooper, Angel
N1 - Funding Information:
Drs. Joshi, Metzler, McCarthy, Olvey, and Kassira received research funding from the study sponsor, Wyeth Research. Ms. Cooper is an employee of Wyeth Research. We thank Jessica Panish for her assistance in preparation of the manuscript.
PY - 2006/9
Y1 - 2006/9
N2 - This randomized, double-blind, multicenter study compared the efficacy and safety of piperacillin/tazobactam (P/T) and imipenem/cilastatin (IMP), both in combination with an aminoglycoside, in hospitalized patients with acute nosocomial pneumonia (NP). Patients with acute NP, defined as pneumonia with symptoms ≥48 h after admission or ≤7 days after hospital discharge, received infusions of 4 g/500 mg P/T or 500 mg/500 mg IMP every 6 h. Endpoints were clinical cure and microbiological response rates; pathogen eradication rates; length of hospital stay; hospital readmissions; and adverse events (AEs). Of 437 patients in the intent-to-treat population, 197 were efficacy evaluable. At test-of-cure, response rates were similar between groups. Within the efficacy evaluable population, 68% of P/T patients and 61% of IMP patients were clinically cured (P = 0.256). Microbiological responses for P/T and IMP patients were: eradication, 64% versus 59%; persistence, 29% versus 21%; relapse, 0% versus 5%; and superinfection, 7% versus 15%, respectively. Gram-positive isolates were eradicated in 83% of P/T patients and 75% of IMP patients; Gram-negative pathogens were eradicated in 72% of P/T patients and 77% of IMP patients. Treatment groups had similar number of mean hospital days, readmission rates, and frequency of AEs. This study showed that P/T administered four times per day was as safe and efficacious as IMP in treating hospitalized patients with NP.
AB - This randomized, double-blind, multicenter study compared the efficacy and safety of piperacillin/tazobactam (P/T) and imipenem/cilastatin (IMP), both in combination with an aminoglycoside, in hospitalized patients with acute nosocomial pneumonia (NP). Patients with acute NP, defined as pneumonia with symptoms ≥48 h after admission or ≤7 days after hospital discharge, received infusions of 4 g/500 mg P/T or 500 mg/500 mg IMP every 6 h. Endpoints were clinical cure and microbiological response rates; pathogen eradication rates; length of hospital stay; hospital readmissions; and adverse events (AEs). Of 437 patients in the intent-to-treat population, 197 were efficacy evaluable. At test-of-cure, response rates were similar between groups. Within the efficacy evaluable population, 68% of P/T patients and 61% of IMP patients were clinically cured (P = 0.256). Microbiological responses for P/T and IMP patients were: eradication, 64% versus 59%; persistence, 29% versus 21%; relapse, 0% versus 5%; and superinfection, 7% versus 15%, respectively. Gram-positive isolates were eradicated in 83% of P/T patients and 75% of IMP patients; Gram-negative pathogens were eradicated in 72% of P/T patients and 77% of IMP patients. Treatment groups had similar number of mean hospital days, readmission rates, and frequency of AEs. This study showed that P/T administered four times per day was as safe and efficacious as IMP in treating hospitalized patients with NP.
KW - Imipenem/cilastatin
KW - Nosocomial pneumonia
KW - Piperacillin/tazobactam
KW - Ventilation, mechanical
KW - Ventilator-associated pneumonia
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UR - http://www.scopus.com/inward/citedby.url?scp=33746216615&partnerID=8YFLogxK
U2 - 10.1016/j.rmed.2006.01.004
DO - 10.1016/j.rmed.2006.01.004
M3 - Article
C2 - 16487695
AN - SCOPUS:33746216615
VL - 100
SP - 1554
EP - 1565
JO - British Journal of Tuberculosis and Diseases of the Chest
JF - British Journal of Tuberculosis and Diseases of the Chest
SN - 0954-6111
IS - 9
ER -