PGY1 Pharmacy Practice Resident, St. John's Hospital, Springfield, Illinois.
Division of Infectious Disease Clinical Pharmacist, Southern Illinois University at Edwardsville, Edwardsville, IL.
Am J Health Syst Pharm. 2016 Jun 1;73(11 Suppl 3):S100-5. doi: 10.2146/sp150041.
The purpose of this study is to evaluate the outcome differences between patients receiving piperacillin-tazobactam pre- and post-implementation of an extended infusion dosing protocol in a community teaching hospital adult intensive care unit.
On December 19th, 2011, extended infusion dosing of piperacillin-tazobactam was implemented at St. John's Hospital's intensive and cardiac care units (ICU/CCU) following IRB-approval. This is a historical case-control cohort study involving review of electronic medical charts of patients who received traditional or extended infusion therapy. Data was collected for patients that received piperacillin-tazobactam in the ICU/CCU from December 19th, 2010 through March 19th, 2011 for traditional infusion and from December 19th, 2011 through March 19th, 2012 for extended infusion. Primary endpoints were ICU/CCU mortality at discharge and length of stay.
The study included 113 patients with 52 in the traditional-infusion group and 61 extended-infusion group. There was no statistically significant difference in the primary end-point of ICU/CCU mortality between the two groups (14.8% vs. 21.1%; p = 0.374). In the extended infusion group, there was a shorter length of ICU and CCU stay (8.32 vs. 12.06 days; p = 0.025) and shorter length of hospital stay (11.32 vs. 19.7 days; p = 0.006). The extended-infusion group showed a decrease in cost of therapy that was statistically significant ($120.21 vs. $155.17; p = 0.035). Adverse drug effects did not differ between the two study groups.
This study showed that treatment with extended-infusion piperacillin-tazobactam therapy improved patient outcomes while maintaining patient safety and decreasing costs.
本研究旨在评估在社区教学医院成人重症监护病房（ICU）实施哌拉西林-他唑巴坦延长输注方案前后，接受该方案治疗的患者结局差异。
2011 年 12 月 19 日，在获得机构审查委员会（IRB）批准后，圣约翰医院的 ICU 和心脏监护病房（ICU/CCU）开始实施哌拉西林-他唑巴坦延长输注方案。这是一项回顾性病例对照队列研究，涉及对接受传统或延长输注治疗的患者电子病历的审查。数据收集时间为 2010 年 12 月 19 日至 2011 年 3 月 19 日期间 ICU/CCU 中接受传统输注治疗的患者，以及 2011 年 12 月 19 日至 2012 年 3 月 19 日期间接受延长输注治疗的患者。主要终点为 ICU/CCU 出院时死亡率和住院时间。
研究纳入 113 例患者，其中传统输注组 52 例，延长输注组 61 例。两组主要终点 ICU/CCU 死亡率无统计学差异（14.8%比 21.1%；p = 0.374）。在延长输注组中，ICU 和 CCU 住院时间更短（8.32 天比 12.06 天；p = 0.025），总住院时间更短（11.32 天比 19.7 天；p = 0.006）。延长输注组治疗费用降低，差异有统计学意义（120.21 美元比 155.17 美元；p = 0.035）。两组患者的药物不良反应无差异。
本研究表明，延长输注哌拉西林-他唑巴坦治疗可改善患者结局，同时保持患者安全并降低成本。
