Treatment of Ventilator‐Associated Pneumonia with Piperacillin‐Tazobactam/Amikacin Versus Ceftazidime/Amikacin: A Multicenter, Randomized Controlled Trial

Autor: S. Brière, C. Brun-Buisson, H. Schweich, J. P. Sollet, C. Petit
Rok vydání: 1998
Předmět:
Zdroj: Clinical Infectious Diseases. 26:346-354
ISSN: 1537-6591
1058-4838
DOI: 10.1086/516294
Popis: In a randomized trial conducted in 27 intensive care units, we compared the clinical efficacy and safety of piperacillin-tazobactam (TAZ; 4 g/0.5 g q.i.d.) and of ceftazidime (CAZ; 1 g q.i.d.), both combined with amikacin (7.5 mg/kg b.i.d.), as therapy for ventilator-associated pneumonia (VAP; acquired after > or =48 hours of mechanical ventilation). VAP was diagnosed with use of protected samples and quantitative cultures, and outcome was assessed blindly from treatment. Of 204 patients suspected of having VAP and randomized to a treatment arm of the study, 127 (64%) had bacteriologically confirmed infections, of which 37% were polymicrobial and 32% involved Pseudomonas aeruginosa; 115 patients (51 TAZ and 64 CAZ recipients) remained evaluable as per protocol. Clinical/bacteriologic cure rates (TAZ vs. CAZ, 51% vs. 36%; 95% confidence interval of difference, -0.2% to 30.2%), and 28-day mortality rates (16% vs. 20%) were similar; however, fewer bacteriologic failures occurred with TAZ (33% vs. 51%; P = .05). We conclude that the two regimens were of equivalent clinical efficacy in therapy for confirmed VAP.
Databáze: OpenAIRE