CLINICAL EFFICACY OF CONTINUOUS INFUSION OF PIPERACILLIN/TAZOBACTAM IN SEVERE PNEUMONIA PATIENTS:A RANDOMIZED CONTROLLED CLINICAL TRIAL

[Objective]To compare the clinical and bacteriological outcome of severe pneumonia patients treated by continuous infusion of piperacillin/tazobactam.[Methods] We conducted an open-label, randomized controlled study in 66 patients clinically diagnosed with severe pneumonia.Patients were randomized to receive piperacillin/tazobactam either by continuous infusion (4.5 g intravenously (iv) over 0.5 h with a loading dose followed by 9g iv daily over 24 h) or intermittent infusion (4.5 g iv every 8 h over 0.5 h).[Results] 66 patients were enrolled in the study, 59 of whom fulfilled the treatment for six days.The CI group (n=32) and Ⅱ group (n=34) were similar in terms of demographics.Intention-to-treat analysis found statistically significant differences in the primary outcomes for clinical success rate (75.0% vs.50.0%, P=0.04), but no significant differences in bacteriological outcomes.Changes in APACHE Ⅱ scores from baseline at the end of the second, third and fourth days were statistically significant (P=0.02, P=0.01 and P=0.04, respectively).The duration of pyrexia and leukocytosis were 3.13±1.01 versus 3.94±0.98 days (P=0.01) and 3.90±0.84 versus 4.29±0.91 days (P=0.10) for CI and Ⅱ groups, respectively.[Conclusion] This study suggests clinical advantages of continuous infusion of piperacillin/tazobactam over intermittent administration in severe pneumonia patients.