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Comparison of Piperacillin/Tazobactam Dosing (13.5 g/day vs. 18 g/day) for the Treatment of Hospital-Acquired Pneumonia and Ventilator-associated Pneumonia in Intensive Care Unit
Korean J Clin Pharm 2018;28(3):167-173
Published online September 30, 2018
© 2018 Korean College of Clinical Pharmacy.

Jeung Yun Kang, Kyung A Lee, Jae Song Kim, Soo Hyun Kim, and Eun Sun Son*

Department of Pharmacy, Severance Hospital, Yon-sei University Health System, Seoul 03722, Republic of Korea
Correspondence to: Eun Sun Son, Department of Pharmacy, Severance Hospital, Yon-sei University Health System, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
Tel: +82-10-3763-6784, Fax: +82-2-312-5732
E-mail: sespharm@yuhs.ac
Received February 11, 2018; Revised May 21, 2018; Accepted May 22, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: In July 2016, the Infectious diseases society of america and the american thoracic society (IDSA & ATS) published a guideline recommending piperacillin/tazobactam (Pip/Tazo) 18 g/day as the anti-pseudomonal dose for the treatment of pathogenic pneumonia. After the guideline was published, the Pip/Tazo dose used for the treatment of pathogenic pneumonia was changed from 13.5 g/day to 18 g/day in a superior general hospital intensive care unit (ICU). In this study, we analyzed the effectiveness and safety of the new dose.
Methods: Adult patients aged ≥19 years who were diagnosed with pneumonia in ICU and who received Pip/Tazo for 7 days or more from September 1, 2015 to May 31, 2017 were included in the study. The electronic medical record (EMR) was retrospectively analyzed.
Results: At baseline, there was a significant difference between 44 patients treated with 13.5 g/day and 31 patients treated with 18 g/day of Pip/Tazo. The 18 g/day-treatment group comprised more elderly patients than the 13.5 g/day-treatment group (p=0.028). The results of the treatment-effects analysis showed no significant difference between the two groups. In case of safety data, there were significant differences in two parameters related to blood count, namely hemoglobin (p=0.016) and platelet count (p=0.011).
Conclusion: Based on the significant difference in baseline age, there is a possibility that high-dose Pip/Tazo showed improved therapeutic effect. However, when high-dose Pip/Tazo was used, the blood cell count was found to drop from the reference value more frequently. Therefore, blood cell count should be monitored carefully when high-dose Pip/Tazo is administered.
Keywords : Pneumonia, piperacillin, tazobactam drug combination, treatment outcomes, safety


September 2018, 28 (3)
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