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小容量注射剂短缺期间哌拉西林/他唑巴坦延长输注与持续输注的评估

Evaluation of Prolonged Versus Continuous Infusions of Piperacillin/Tazobactam During Shortages of Small Volume Parenteral Solutions.

作者信息

Tschumper Emily, Dupuis Kaitlyn, McCrory Kim, Pitts Wes

机构信息

University of Mississippi, University, MS, USA.

North Mississippi Medical Center, Tupelo, MS, USA.

出版信息

J Pharm Technol. 2021 Dec;37(6):271-277. doi: 10.1177/87551225211034978. Epub 2021 Jul 23.

Abstract

In 2017, a national drug shortage of small volume solutions significantly affected the preparation of intravenous antibiotics. In response, a continuous infusion administration protocol for piperacillin/tazobactam (PIP/TAZ) was implemented. To compare the outcomes of continuous to prolonged infusions of PIP/TAZ in the setting of drug shortages. This study is a single-center, retrospective cohort study in a community hospital of patients 18 years and older who received intravenous PIP/TAZ through 2 different dosing strategies of intravenous antibiotics from December 2016 to January 2018. Data were collected for 2 months on patients receiving prolonged infusions of PIP/TAZ prior to November 2017 and for 2 months on patients receiving continuous infusions of PIP/TAZ after November 2017. A total of 90 patients who received PIP/TAZ via either prolonged (n = 47) or continuous infusion (n = 43) were evaluated. There were no differences between the groups in mortality (3 vs 2 deaths, = 1.00), length of therapy (6 ± 4 vs 6 ± 3 days, = .86), or length of stay (9 ± 7 vs 8 ± 6 days, = .47). Additionally, no differences were noted between incidences of thrombocytopenia ( = .41), infection ( = .48), acute renal failure ( = 1.00), seizures ( = 1.0), or 30-day readmission rates ( = .27). Administration of continuous infusion PIP/TAZ appears to be a viable mitigation strategy during small volume fluid shortages. Future cost-effectiveness studies may provide information on the financial impact of continuous infusions during costly drug shortages.

摘要

2017年,小容量溶液的全国性药品短缺严重影响了静脉用抗生素的配制。作为应对措施,实施了哌拉西林/他唑巴坦(PIP/TAZ)持续静脉输注给药方案。为比较在药品短缺情况下PIP/TAZ持续输注与延长输注的效果。本研究是一项在社区医院进行的单中心回顾性队列研究,研究对象为2016年12月至2018年1月期间18岁及以上、通过两种不同静脉抗生素给药策略接受静脉PIP/TAZ治疗的患者。收集了2017年11月之前接受PIP/TAZ延长输注患者的2个月数据,以及2017年11月之后接受PIP/TAZ持续输注患者的2个月数据。总共评估了90例通过延长输注(n = 47)或持续输注(n = 43)接受PIP/TAZ治疗的患者。两组在死亡率(3例死亡对2例死亡,P = 1. 在治疗时长(6±4天对6±3天,P = 0.86)或住院时长(9±7天对8±6天,P = 0.47)方面无差异。此外,在血小板减少症发生率(P = 0.41)、感染(P = 0.48)、急性肾衰竭(P = 1.00)、癫痫发作(P = 1.0)或30天再入院率(P = 0.27)方面也未发现差异。在小容量液体短缺期间,持续输注PIP/TAZ似乎是一种可行的缓解策略。未来的成本效益研究可能会提供有关昂贵药品短缺期间持续输注的财务影响的信息。 (注:原文中部分“ = ”应是“P = ”,翻译时已修正)

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