Comparison of piperacillin/tazobactam and imipenem/cilastatin, both in combination with tobramycin, administered every 6 h for treatment of nosocomial pneumonia

Manjari Joshi, Michael Metzler, Mary McCarthy, Stephen Olvey, Wedad Kassira, Angel Cooper

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1554-1565
Number of pages12
JournalRespiratory Medicine
Volume100
Issue number9
DOIs
StatePublished - Sep 1 2006

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Keywords

  • Imipenem/cilastatin
  • Nosocomial pneumonia
  • Piperacillin/tazobactam
  • Ventilation, mechanical
  • Ventilator-associated pneumonia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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