Gould I M, Ansari A, Harvey G, Douglas J G, Smith C C, Reid T M
Regional Laboratory, City Hospital, Aberdeen, UK.
Drugs Exp Clin Res. 1991;17(3):187-90.
Twenty-five consecutive patients admitted to hospital with severe soft tissue infection were entered into an open trial designed to evaluate safety and efficacy of the drug combination tazobactam/piperacillin. The dosage regimen was 4 g piperacillin/500 mg tazobactam Q8H. There were twenty cases of uncomplicated cellulitis and five cases with associated abscess formation. These five cases required adjunctive surgical drainage. Mean duration of therapy was 7.6 days. No other antibiotics were administered unless treatment with the study drug failed. There were eight treatment failures, six related to the trial drug. Four patients developed an allergic response to the trial drug, necessitating a change of therapy. Three patients failed to respond; all three had acute cellulitis in association with peripheral vascular disease. Significant bacterial isolates were grown in thirteen patients; Group A streptococci in three, S. aureus in five, other pathogenic streptococci in four and coliforms or Ps. aeruginosa in five. The majority of isolates except the streptococci were resistant to piperacillin but all isolates except one strain of Ps. aeruginosa were susceptible to the combination. The combination is suitable for the treatment of serious soft tissue infection, but increased doses may be appropriate in infection at poorly perfused sites.
连续25例因严重软组织感染入院的患者进入一项开放试验，该试验旨在评估他唑巴坦/哌拉西林联合用药的安全性和有效性。给药方案为哌拉西林4g/他唑巴坦500mg，每8小时一次。其中20例为单纯性蜂窝织炎，5例伴有脓肿形成。这5例患者需要辅助手术引流。平均治疗时间为7.6天。除非研究药物治疗失败，否则不使用其他抗生素。共有8例治疗失败，其中6例与试验药物有关。4例患者对试验药物出现过敏反应，需要更换治疗方案。3例患者无反应；这3例均患有急性蜂窝织炎并伴有周围血管疾病。13例患者培养出重要的细菌分离株；3例为A组链球菌，5例为金黄色葡萄球菌，4例为其他致病性链球菌，5例为大肠埃希菌或铜绿假单胞菌。除链球菌外，大多数分离株对哌拉西林耐药，但除1株铜绿假单胞菌外，所有分离株对联合用药敏感。该联合用药适用于治疗严重软组织感染，但在灌注不良部位的感染中可能需要增加剂量。
