Extended infusion of piperacillin-tazobactam versus intermittent infusion in critically ill egyptian patients: a cost-effectiveness study.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Gram-Negative Bacterial Infections*/microbiology ; Piperacillin*/therapeutic use; Anti-Bacterial Agents/therapeutic use ; Cost-Benefit Analysis ; Critical Illness/therapy ; Egypt ; Humans ; Infusions, Intravenous ; Penicillanic Acid/adverse effects ; Piperacillin, Tazobactam Drug Combination/therapeutic use ; Prospective Studies

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.
(© 2022. The Author(s).)

Comment in: Indian J Med Microbiol. 2023 Mar-Apr;42:110-111. doi: 10.1016/j.ijmmb.2022.09.003. (PMID: 36175196)

Am J Med. 1979 Oct;67(4):608-16. (PMID: 495630)
J Crit Care. 2005 Jun;20(2):187-91; discussion 191-3. (PMID: 16139163)
J Intensive Care Med. 2017 Jan;32(1):25-37. (PMID: 26772199)
Eur J Clin Microbiol Infect Dis. 2017 Mar;36(3):459-466. (PMID: 27796647)
BMC Infect Dis. 2020 Jun 20;20(1):430. (PMID: 32563242)
Clin Infect Dis. 2013 Jan;56(2):272-82. (PMID: 23074314)
Nephron Clin Pract. 2012;120(4):c179-84. (PMID: 22890468)
JAMA. 2013 Nov 27;310(20):2191-4. (PMID: 24141714)
J Infect. 2020 Dec;81(6):895-901. (PMID: 33031834)
Clin Infect Dis. 2007 Feb 1;44(3):357-63. (PMID: 17205441)
Int J Clin Pharm. 2016 Oct;38(5):1087-93. (PMID: 27333796)
PLoS One. 2015 Jan 09;10(1):e0116769. (PMID: 25575030)
Ann Pharmacother. 2013 Feb;47(2):170-80. (PMID: 23341160)
Am J Respir Crit Care Med. 2015 Dec 1;192(11):1298-305. (PMID: 26200166)
Int J Clin Pharm. 2016 Feb;38(1):70-9. (PMID: 26474861)
PLoS One. 2012;7(11):e49845. (PMID: 23185458)
Pharmacotherapy. 2002 Apr;22(4):471-83. (PMID: 11939682)
Basic Clin Pharmacol Toxicol. 2021 Jan;128(1):4-8. (PMID: 32955760)
Pharmacotherapy. 2016 May;36(5):463-71. (PMID: 26952639)
J Pharm Pract. 2017 Dec;30(6):593-599. (PMID: 29121839)
Antimicrob Agents Chemother. 2010 Jan;54(1):460-5. (PMID: 19858253)
Pharmacotherapy. 2017 Jan;37(1):109-119. (PMID: 27888542)
J Pediatr Pharmacol Ther. 2016 Jul-Aug;21(4):332-338. (PMID: 27713673)
Ann Pharmacother. 2015 Jul;49(7):754-60. (PMID: 25855703)

0 (Anti-Bacterial Agents)
157044-21-8 (Piperacillin, Tazobactam Drug Combination)
87-53-6 (Penicillanic Acid)
X00B0D5O0E (Piperacillin)

Date Created: 20220627 Date Completed: 20220629 Latest Revision: 20230609

20250114

PMC9237083

10.1038/s41598-022-12861-7

35760971