Clinical Pharmacy Department, Faculty of Pharmacy, The British University in Egypt (BUE) Cairo, P.O.BOX 43, Cairo, 11837, Egypt.
Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
Sci Rep. 2022 Jun 27;12(1):10882. doi: 10.1038/s41598-022-12861-7.
Extended infusion of piperacillin/tazobactam over 4 h has been proposed as an alternate mode of administration to the 30-min intermittent infusion to optimize treatment effects in patients with gram-negative bacterial infections. The study aimed to evaluate the extended infusion regimen of piperacillin/tazobactam in standings of efficacy, safety, and cost to the intermittent one in the treatment of gram-negative bacterial infections. A prospective randomized comparative study was performed on 53 patients, 27 in the intermittent infusion group and 26 in the extended infusion group. The primary outcome was the mean number of days to clinical success and the percentage of patients who were clinically cured after treatment. The secondary outcomes included mortality, readmission within 30-days, and cost-effectiveness analysis based on the mean number of days to clinical success. The clinical success rate was comparable in the two groups. Days on extended infusion were significantly lower than intermittent infusion (5.7 vs 8.9 days, respectively, p = 0.0001) as well as days to clinical success (4.6 vs 8.5 days, respectively, p = 0.026). The extended infusion was superior to the intermittent infusion regarding cost-effectiveness ratio ($1835.41 and $1914.09/expected success, respectively). The more cost-effective regimen was the extended infusion. Both regimens had comparable clinical and microbiological outcomes.
哌拉西林/他唑巴坦的 4 小时持续输注已被提议作为 30 分钟间歇性输注的替代给药方式，以优化革兰氏阴性菌感染患者的治疗效果。本研究旨在评估哌拉西林/他唑巴坦的持续输注方案在治疗革兰氏阴性菌感染时的疗效、安全性和成本相对于间歇性输注的优劣。对 53 例患者进行了前瞻性随机对照研究，其中 27 例患者接受间歇性输注，26 例患者接受持续输注。主要结局是临床治愈的平均天数和治疗后临床治愈的患者百分比。次要结局包括死亡率、30 天内再入院率和基于临床治愈平均天数的成本效益分析。两组的临床治愈率相当。持续输注组的天数明显低于间歇性输注组（分别为 5.7 天和 8.9 天，p=0.0001），临床治愈天数也明显低于间歇性输注组（分别为 4.6 天和 8.5 天，p=0.026）。与间歇性输注相比，持续输注在成本效益比方面更具优势（分别为 1835.41 美元和 1914.09 美元/预期治愈率）。更具成本效益的方案是持续输注。两种方案在临床和微生物学结局方面具有可比性。
