Abstract
Pseudomonas aeruginosa remains an important pathogen. Our purpose was to determine the minimum inhibitory con-centration (MIC) and pharmacodynamic (PD) parameters predicting a positive response to therapy with piperacil-lin-tazobactam. Medical records were retrospectively reviewed at 3 centers. Data were recorded to assess age, type of disease, renal function, weight (body mass), MIC, antimicrobial treatment, and clinical outcome. Success was response to piperacillin-tazobactam alone, or in combination with another active agent; failure was lack of response. Of 78 eva-luable patients, 63 responded (7 UTI; 56 non-UTI) and 15 did not; 26 responding received combination therapy and 37 monotherapy. Piperacillin-tazobactam treatment was successful in 53 of 63 of non-UTI disease with a MIC of ≤64/4 μg/mL, but in only 3 of 7 with a MIC of >64/4 μg/mL (P = 0.023); overall 9 of 10 infections by strains with MICs = 32 - 64 μg/mL had a successful outcome. Piperacillin estimated time above MIC at 20% separated those responding from those that did not (P = 0.019).
Highlights
The global plague of antibiotic resistant infections is recognized as a serious threat to world-wide healthcare [1]
Our purpose was to determine the minimum inhibitory concentration (MIC) and pharmacodynamic (PD) parameters predicting a positive response to therapy with piperacillin-tazobactam
The purpose of this study was to collect data that would determine what susceptibility breakpoint reliably predicts clinical success when piperacillin-tazobactam is used for therapy of P. aeruginosa infection at adequate doses and what pharmacodynamic parameter(s) can guide in predicting human clinical response
Summary
The global plague of antibiotic resistant infections is recognized as a serious threat to world-wide healthcare [1]. This has been accompanied by a steady decline in the research and development of new antimicrobial agents to deal with the challenge. One of the key pathogen groups included in this threat are multidrug-resistant, increasingly pan-resistant, Gram-negative bacilli [1,2]. In this group is Pseudomonas aeruginosa, which remains an important pathogen that is steadily becoming more resistant to antimicrobial agents [3,4]. Therapy of serious infection with P. aeruginosa has been accomplished with a combination of agents owing to the frequent resistance seen in this pathogen [5]
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