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Antimicrobial Agents and Chemotherapy, November 2006, p. 3556-3561, Vol. 50, No. 11
0066-4804/06/$08.00+0     doi:10.1128/AAC.00329-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Randomized, Open-Label, Comparative Study of Piperacillin-Tazobactam Administered by Continuous Infusion versus Intermittent Infusion for Treatment of Hospitalized Patients with Complicated Intra-Abdominal Infection{triangledown}

William K. Lau,1* David Mercer,2 Kamal M. Itani,3 David P. Nicolau,4 Joseph L. Kuti,4 Debra Mansfield,5 and Adrian Dana5

The Queens Medical Center, Honolulu, Hawaii,1 University of Texas, Houston, Texas,2 Boston VA Health Care System and Boston University, Boston, Massachusetts,3 Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut,4 Wyeth Pharmaceuticals, Collegeville, Pennsylvania5

Received 16 March 2006/ Returned for modification 21 April 2006/ Accepted 17 August 2006

The purpose of this randomized, multicenter, open-label study was to compare the continuous infusion of piperacillin-tazobactam with the standard intermittent infusion in 262 hospitalized patients with complicated intra-abdominal infections. Within 1 day of surgical intervention, eligible patients were randomized (1:1) to piperacillin-tazobactam 12 g/1.5 g administered continuously over 24 h or 3 g/0.375 g administered over 30 min intermittently every 6 h for 4 to 14 days. The demographics of the patients in the groups were similar, with a median APACHE II score of 7 and a median length of hospitalization of 7 days. Among 167 clinically evaluable patients, 86.4% and 88.4% of the patients treated with the continuous infusion and the intermittent infusion, respectively, were clinically cured or improved at the test-of-cure visit (P = 0.817). Bacteriological success was observed in 83.9% and 87.9% of patients (P = 0.597) in the two groups, respectively, and no differences in bacteriological response by pathogen were noted. Defervesence and white blood cell count normalization occurred in the majority of patients within 3 days and were similar between patients receiving the continuous infusion and those receiving the intermittent infusion. Drug-related adverse events were generally mild and were reported in similar numbers of patients in each arm of the trial. The results of this study support continuous infusion as a safe and reasonable alternate mode of administration of piperacillin-tazobactam for the treatment of complicated intra-abdominal infection.

* Corresponding author. Mailing address: The Queens Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813. Phone: (808) 532-2955. Fax: (808) 532-2960. E-mail: laue002{at}hawaii.rr.com.

{triangledown} Published ahead of print on 28 August 2006.

Antimicrobial Agents and Chemotherapy, November 2006, p. 3556-3561, Vol. 50, No. 11
0066-4804/06/$08.00+0     doi:10.1128/AAC.00329-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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