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OBJECTIVE:To provide reference for clinical rational use of piperacillin sulbactam for the anti-infection of Pseudo-monas aeruginosa. METHODS:105 inpatients with normal liver and kidney functions that the pathogen was diagnosed as P. aerugi-nosa and susceptible to PIP/SBT from Jul. 2013 to Jun. 2014 were chose,dosing regimens were collected,the minimum inhibitory concentration (MIC) of piperacillin sulbactam for P. aeruginosa was 1 mg/L based on a one compartment pharmacokinetic mode, the standard value of the percentage of the duration of plasma concentration more than MIC(T>MIC)to dosing interval time was 45%,T>MIC was calculated with pharmacokinetic formula of both single dose and multiple dose repeated intravenous administra-tion to analyze the situation of reaching the standard of T>MIC;and the dosing interval time of the original scheme was prolonged appropriately to investigate the situation of reaching the standard of the percentage of (T>MIC) to dosing interval time. RE-SULTS:47 patients’dosing regimens were given 3.0 g PIP/SBT once every 8 hours,and the others were given 3.0 g PIP/SBT once every 12 hours;for P. aeruginosa,the percentages of T>MIC to dosing interval time were respectively 99.93% and 73.13% with pharmacokinetic formula of single dose intravenous administration,and 99.98%and 68.08%with pharmacokinetic formula of multi-ple dose repeated intravenous administration;and the percentages of the interval time prolonged to 16 h were respectively 54.84%and 51.06%,both reached the standard value. CONCLUSIONS:Quantitative analysis of PK/PD prediction parameters can be used to evaluate and optimize the clinical dosing regimens and guide the clinical practice.
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Objective To evaluate the clinical efficacy and safety of piperacillin and sulbactam sodium combinations in the treatment of common infections. Methods This was a multi-centre, prospective and open study. All subjects from 57 wards caught common infection like respiratory ( RTI) or urinary diseases ( UTI). The dosages of piperacillin and sulbactam sodium combinations 2. 5 g injection were determined according to indications:for adult, 2. 5 g or 5 g per time, 2 time/day; for severe or obstinate infection, 2.5 g or 5 g per time, 3 time/day. General information, clinical response pre- and posttreatment, infected locus, drug recipe and protocol, prognosis and adverse reaction were recorded. Results Data of 579 cases were collected with 388 males and 191 females. The average age was (66. 8 ± 17. 0) years. There were 500 patients who were suffering with RTI, with 362 cases of pneumonia, 102 of acute exacerbation of chronic bronchitis, and 36 of other infections. There were 50 cases with UTI, with 31 of simple urinary tract infection, and 19 of complex urinary tract infection. In addition, there were 9 cases of combined RTI and UTI, and 20 of other infections including peritonitis. The average duration of antimicrobial for RTI and UTI was (8. 65 ± 3. 78 ) days and (7. 45 ± 3. 46) days respectively with the total efficacy rate was 92. 6% and 98. 0% respectively for RTI and UTI. The incidence of adverse events was only 0.86% (5 cases), including nausea, rash, itching, ALT elevation and suspected drug induced fever in each one. Conclusion Piperacillin and sulbactam sodium compound had high clinical efficacy and safety in the treatment of common infections including RTI and UTI.
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Objective To evaluate the in vitro antimicrobial activity of piperacillin-sulbactam against clinical isolates of non-fermentative bacilli isolated from common infections. Methods Microdilution was employed to study the antimicrobial resistance. Results A total of 770 strains were collected from 6 hospitals in Guangzhou, including Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia , Burkholderia cepacia , Flavobacterium , and Alcaligenes. Compared with other β-lactams,piperacillin-sulbactam displayed the highest activity against all the isolates of P. aeruginosa, especially for imipenem non-sensitive isolates, with the susceptibility of 71.9% and 55.8%, respectively. Piperacillinsulbactam and cefoperazone-sulbactam kept good activity against imipenem sensitive isolates of A. baumannii,with the susceptibility of 71.0% and 73. 0%, respectively. For the strains of Burkholderia cepacia, 69% strains exhibited minimal inhibitory concentration (MIC) of ≤ 16 mg/L for piperacillin-sulbactam. For the strains of Flavobacterium, and Alcaligenes, piperacillin-sulbactam also had excellent activity, with the susceptibility of 70. 2% and 94. 4%, respectively. Conclusion Piperacillin-sulbactam exhibits good activity again non-fermentative bacilli, especial for imipenem non-sensitive isolates of P. aeruginosa.
ABSTRACT
BACKGROUND: Combicin(R) is a new product of beta- lactam and beta-lactamase inhibitor combination which has antibacterial activity against aerobic and anaerobic bacteria, comprised of piperacillin and sulbactam. A phase III randomized clinical trial of Combicin(R) was done to evaluate and compare the efficacy and safety of piperacillin/sulbactam (Combicin(R)) with piperacillin in the treatment of urinary tract infection. METHODS: A total of 128 adult patients with acute urinary tract infection were enrolled and randomized into one of the two treatment groups during the period from August 1997 to September 1999 in Severance Hospital and Asan Medical Center, Seoul, Korea. Sixty-five patients were excluded in the analysis according to the exclusion criteria, and the rest 63 patients (3 men, 60 women) were eligible for the study. Clinical and bacteriologic responses were evaluated at entry and during the study period. Adverse effects were monitored by daily examination of the patients and periodic evaluations of laboratory findings. Statistical analyses were done by Chi-square test, Fisher's exact test, and Student t-test. RESULTS: Symptoms and signs such as fever, pyuria, dysuria, frequency, tenesmus, and costovertebral angle tenderness showed improvement in both group. Most commonly isolated microorganism was E. coli. The bacteriological eradication was found in 96.7% of the Combicin(R)-treated patients and in 90.9% of the piperacillin-treated patients. Adverse drug reactions in Combicin(R)-treated patients and piperacillin-treated patients occurred in 3.33% (2/60) and 5.88% (4/68) of the patients, respectively. Adverse events included liver function test elevation, drug fever, rash, indigestion, leukopenia, and nausea. Combicin(R) was well tolerated and side effects were negligible. CONCLUSION: Combicin(R) is safe and effective in the treatment of urinary tract infections.