File T M, Tan J S
Department of Medicine, Akron City Hospital, Ohio.
Eur J Surg Suppl. 1994(573):51-5.
Piperacillin/tazobactam has excellent in vitro activity against the most pathogens involved in skin infections. Two large multicentre studies recently evaluated the efficacy and safety of piperacillin/tazobactam in the treatment of skin and soft tissue infections in patients in hospital. The efficacy and safety of piperacillin/tazobactam (4 g/500 mg every 8 hours) have been assessed in an open study in Europe. Among 120 evaluable patients, 93% were clinically cured or improved. Only six patients were withdrawn from the study because of side effects. In another trial, piperacillin/tazobactam were compared with ticarcillin/clavulanate in a double-blinded prospective study in the United States. Of evaluable patients, 67 received piperacillin/tazobactam (3 g/375 mg every 6 hours) and 44 received ticarcillin/clavulanate (3 g/100 mg every 6 hours). At assessment, 76% of patients given piperacillin/tazobactam and 77% of patients given ticarcillin/clavulanate had responded favourably. The lower success rate in this trial may be attributed to more stringent inclusion criteria that resulted in the incorporation of a higher proportion of patients with more severe conditions including diabetic/ischaemic foot infections. The incidence of adverse reactions was similar in both groups. Piperacillin/tazobactam seems to be both effective and safe in the treatment of skin and soft tissue infections in patients confined to hospital.
哌拉西林/他唑巴坦对大多数引起皮肤感染的病原体具有出色的体外活性。最近两项大型多中心研究评估了哌拉西林/他唑巴坦治疗住院患者皮肤和软组织感染的疗效和安全性。在欧洲的一项开放性研究中评估了哌拉西林/他唑巴坦（每8小时4g/500mg）的疗效和安全性。在120例可评估患者中，93%临床治愈或病情改善。仅有6例患者因副作用退出研究。在另一项试验中，在美国的一项双盲前瞻性研究中，将哌拉西林/他唑巴坦与替卡西林/克拉维酸进行了比较。在可评估患者中，67例接受哌拉西林/他唑巴坦（每6小时3g/375mg），44例接受替卡西林/克拉维酸（每6小时3g/100mg）。评估时，接受哌拉西林/他唑巴坦治疗的患者中有76%反应良好，接受替卡西林/克拉维酸治疗的患者中有77%反应良好。该试验中较低的成功率可能归因于更严格的纳入标准，导致纳入了更高比例病情更严重的患者，包括糖尿病/缺血性足部感染患者。两组不良反应发生率相似。哌拉西林/他唑巴坦在治疗住院患者皮肤和软组织感染方面似乎既有效又安全。
