Clinical Effect and Efficacy Factors of Modified Piperacillin-Tazobactam Dosing Regimens in Abdominal Tumor Patients with Post-Operative Pneumonia.

BACKGROUND

This study was conducted to observe the clinical efficacy of long-term piperacillin-tazobactam (TZP) infusion and identify the factors affecting its curative effect against pneumonia in patients who had undergone surgery for abdominal tumor.

METHODS

The 100 patients were divided into four clinical groups according to the severity of their infection: Simple pneumonia, pneumonia with pleural effusion, pneumonia and atelectasis, and severe pneumonia. Each group of patients was then divided into control and treatment groups using a completely random design. The control group received TZP as a regular infusion, and the treatment group received TZP as a long-term infusion. The cure time in the different groups was compared according to the administration regimen, and stratified analysis was carried out to identify the efficacy factors of long-term TZP infusion for patients with each kind of pneumonia.

RESULTS

The average cure time for TZP differed significantly among the groups. In particular, the average cure times in the simple pneumonia, pneumonia with pleural effusion, pneumonia and atelectasis, and severe pneumonia groups were 6.800 ± 0.342, 7.320 ± 0.304, 10.840 ± 0.571, and 15.942 ± 0.973 d (p < 0.001). In each group, the usage time of antibiotics in the treatment groups was significantly shorter than in the control group (8.87 ± 0.64 vs. 15.95 ± 2.02 d; p < 0.001). The cure times (d) for simple pneumonia and pneumonia and atelectasis were conspicuously lower in the treatment groups than in the control group (5.667 ± 0.256 vs. 7.846 ± 0.451; p < 0.001; 9.667 ± 1.432 vs. 11.923 ± 0.947; p = 0.024). The factors associated with continuous treatment effectiveness were being male, age <70 years, Acute Physiology and Chronic Health Evaluation score ≥17 points, minimum inhibitory concentration of the pathogen 8 mcg/mL, oxygenation index >200 mm Hg, serum procalcitonin concentration >4 ng/mL, and serum albumin <25 g/L.

CONCLUSION

Long-term TZP infusion exhibited better clinical efficacy than did traditional treatment in patients with pneumonia after abdominal tumor surgery.