Sanders W E, Sanders C C
Department of Medical Microbiology, Creighton University School of Medicine, Omaha, Nebraska, USA.
Clin Infect Dis. 1996 Jan;22(1):107-23. doi: 10.1093/clinids/22.1.107.
Piperacillin/tazobactam is the most recently approved combination of a beta-lactam agent with an inhibitor of bacterial beta-lactamases. It has a broader spectrum than do preceding inhibitor-drug combinations, and it is generally more potent. In terms of clinical and microbiological outcomes, comparative studies have shown that piperacillin/tazobactam was comparable to imipenem (1.0 g q8h) and to clindamycin plus gentamicin for intraabdominal infections, to clindamycin plus gentamicin for infections of the skin and skin structures and pelvic tissues in women, and to ticarcillin/clavulanate for skin and soft-tissue infections. Piperacillin/tazobactam was statistically superior to imipenem (0.5 g q8h) for intraabdominal infections, to ticarcillin/clavulanate for community-acquired lower respiratory tract infections, and to ceftazidime for nosocomial lower respiratory tract infections and febrile episodes in neutropenic patients. Adverse effects with piperacillin/tazobactam were generally of only mild-to-moderate severity. Piperacillin/tazobactam may be especially useful for the treatment of infections that are likely to be polymicrobial or to be due to any one of an array of aerobic or anaerobic bacteria; this agent may also be useful in situations where organisms with plasmid-mediated beta-lactamases have become problematic.
哌拉西林/他唑巴坦是最近批准的一种β-内酰胺类药物与细菌β-内酰胺酶抑制剂的联合制剂。它比先前的抑制剂-药物联合制剂具有更广泛的抗菌谱，并且通常更具效力。在临床和微生物学结果方面，比较研究表明，哌拉西林/他唑巴坦在治疗腹腔感染方面与亚胺培南（1.0 g，每8小时一次）及克林霉素加庆大霉素相当，在治疗女性皮肤及皮肤结构感染和盆腔组织感染方面与克林霉素加庆大霉素相当，在治疗皮肤和软组织感染方面与替卡西林/克拉维酸相当。在腹腔感染方面，哌拉西林/他唑巴坦在统计学上优于亚胺培南（0.5 g，每8小时一次）；在社区获得性下呼吸道感染方面，优于替卡西林/克拉维酸；在医院获得性下呼吸道感染及中性粒细胞减少患者的发热性发作方面，优于头孢他啶。哌拉西林/他唑巴坦的不良反应一般仅为轻至中度。哌拉西林/他唑巴坦可能对治疗可能为多微生物感染或由一系列需氧或厌氧菌中的任何一种引起的感染特别有用；在质粒介导的β-内酰胺酶所致微生物引起问题的情况下，该药物可能也有用。
