Unidade de Cuidados Intensivos Polivalente, Hospital São Francisco Xavier Hospital, CHLO, Lisboa, Portugal.
PLoS One. 2012;7(11):e49845. doi: 10.1371/journal.pone.0049845. Epub 2012 Nov 21.
The clinical efficacy of continuous infusion of piperacillin/tazobactam in critically ill patients with microbiologically documented infections is currently unknown. We conducted a retrospective multicenter cohort study in 7 Portuguese intensive care units (ICU). We included 569 critically ill adult patients with a documented infection and treated with piperacillin/tazobactam admitted to one of the participating ICU between 2006 and 2010. We successfully matched 173 pairs of patients according to whether they received continuous or conventional intermittent dosing of piperacillin/tazobactam, using a propensity score to adjust for confounding variables. The majority of patients received 16g/day of piperacillin plus 2g/day of tazobactam. The 28-day mortality rate was 28.3% in both groups (p = 1.0). The ICU and in-hospital mortality were also similar either in those receiving continuous infusion or intermittent dosing (23.7% vs. 20.2%, p = 0.512 and 41.6% vs. 40.5%, p = 0.913, respectively). In the subgroup of patients with a Simplified Acute Physiology Score (SAPS) II>42, the 28-day mortality rate was lower in the continuous infusion group (31.4% vs. 35.2%) although not reaching significance (p = 0.66). We concluded that the clinical efficacy of piperacillin/tazobactam in this heterogeneous group of critically ill patients infected with susceptible bacteria was independent of its mode of administration, either continuous infusion or intermittent dosing.
哌拉西林/他唑巴坦持续输注在确诊感染的危重症患者中的临床疗效尚不清楚。我们在葡萄牙的 7 家重症监护病房（ICU）进行了一项回顾性多中心队列研究。纳入 2006 年至 2010 年间入住参与研究的 ICU 的 569 例确诊感染且接受哌拉西林/他唑巴坦治疗的成年危重症患者。采用倾向评分调整混杂变量，成功匹配了 173 对接受连续或常规间歇性哌拉西林/他唑巴坦给药的患者。大多数患者接受 16g/天哌拉西林加 2g/天他唑巴坦治疗。两组 28 天死亡率相似（28.3%，p=1.0）。连续性输注组和间歇性给药组的 ICU 死亡率和院内死亡率也相似（23.7%比 20.2%，p=0.512 和 41.6%比 40.5%，p=0.913）。在简化急性生理学评分（SAPS）II>42 的患者亚组中，连续输注组的 28 天死亡率较低（31.4%比 35.2%），但无统计学意义（p=0.66）。我们得出结论，在该组感染敏感细菌的危重症患者中，哌拉西林/他唑巴坦的临床疗效与其给药方式（连续输注或间歇性给药）无关。
