Clinical Benefits of Piperacillin/Tazobactam versus Ei a Combination of Ceftriaxone and Clindamycin in the Treatment of Early, Non-Ventilator, Hospital-Acquired Pneumonia in a Community-Based Hospital
- Authors
- Park, GE[Park, Ga Eun]; Ko, JH[Ko, Jae-Hoon]; Ki, HK[Ki, Hyun Kyun]
- Issue Date
- 2020
- Publisher
- DOVE MEDICAL PRESS LTD
- Keywords
- empirical antibiotics; hospital-acquired infection; pneumonia; multiple drug resistance
- Citation
- INTERNATIONAL JOURNAL OF GENERAL MEDICINE, v.13, pp.705 - 712
- Journal Title
- INTERNATIONAL JOURNAL OF GENERAL MEDICINE
- Volume
- 13
- Start Page
- 705
- End Page
- 712
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/6932
- DOI
- 10.2147/IJGM.S271301
- ISSN
- 1178-7074
- Abstract
- Purpose: There is an increasing prevalence of multidrug-resistant (IVIDR) organisms worldwide. Therefore, broad-spectrum antibiotics are recommended in the treatment of hospitalacquired pneumonia (HAP). However, it remains controversial whether patients with early onset, non-ventilator HAP (NV-HAP) should also be empirically treated with broad-spectrum antibiotics. We compared the clinical benefit of ceftriaxone plus clindamycin vs piperacillin/tazobactam as the initial empirical treatment of adults with early NV-HAP. Patients and Methods: Retrospective cohort study was conducted in adult patients who were diagnosed with early, NV-HAP between January 2013 and June 2017 at a community-based tertiary care hospital. Patients were eligible for inclusion if they had received empiric treatment with either ceftriaxone and clindamycin or piperacillin/tazobactam for at least 3 days. Patients with increased risk of MDR pathogens were excluded. Results: A total of 89 patients were treated with ceftriaxone and clindamycin, while 124 received piperacillin/tazobactam. There were no significant differences between the two antibiotic groups with regard to median age, sex, or risk of pneumonia. The 30-day all-cause mortality did not differ significantly between the ceftriaxone plus clindamycin and piperacillin/tazobactam groups (4.5% vs 1.6%, P=0.202, respectively). However, in multi-variate analysis, clinical failure was more frequent in the ceftriaxone plus clindamycin group than in the piperacillin/tazobactam group (HR 3.316; 95% CI, 1.589-6918, P=0.001). Conclusion: Treatment with piperacillin/tazobactam was more effective than that with ceftriaxone plus clindamycin in patients with early NV-HAP. This study supports the recent treatment recommendations that patients with early NV-HAP should be treated empirically with broad-spectrum antibiotics.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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