Continuous infusion of piperacillin/tazobactam in septic critically ill patients--a multicenter propensity matched analysis

PLoS One. 2012;7(11):e49845. doi: 10.1371/journal.pone.0049845. Epub 2012 Nov 21.

Abstract

The clinical efficacy of continuous infusion of piperacillin/tazobactam in critically ill patients with microbiologically documented infections is currently unknown. We conducted a retrospective multicenter cohort study in 7 Portuguese intensive care units (ICU). We included 569 critically ill adult patients with a documented infection and treated with piperacillin/tazobactam admitted to one of the participating ICU between 2006 and 2010. We successfully matched 173 pairs of patients according to whether they received continuous or conventional intermittent dosing of piperacillin/tazobactam, using a propensity score to adjust for confounding variables. The majority of patients received 16g/day of piperacillin plus 2g/day of tazobactam. The 28-day mortality rate was 28.3% in both groups (p = 1.0). The ICU and in-hospital mortality were also similar either in those receiving continuous infusion or intermittent dosing (23.7% vs. 20.2%, p = 0.512 and 41.6% vs. 40.5%, p = 0.913, respectively). In the subgroup of patients with a Simplified Acute Physiology Score (SAPS) II>42, the 28-day mortality rate was lower in the continuous infusion group (31.4% vs. 35.2%) although not reaching significance (p = 0.66). We concluded that the clinical efficacy of piperacillin/tazobactam in this heterogeneous group of critically ill patients infected with susceptible bacteria was independent of its mode of administration, either continuous infusion or intermittent dosing.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Bacteria* / drug effects
  • Bacteria* / isolation & purification
  • Bacteria* / pathogenicity
  • Critical Illness / mortality
  • Critical Illness / therapy
  • Female
  • Humans
  • Infections / drug therapy*
  • Infections / microbiology
  • Infections / mortality
  • Infections / pathology
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Penicillanic Acid / administration & dosage
  • Penicillanic Acid / analogs & derivatives
  • Piperacillin / administration & dosage
  • Piperacillin, Tazobactam Drug Combination
  • Portugal

Substances

  • Anti-Bacterial Agents
  • Piperacillin, Tazobactam Drug Combination
  • Penicillanic Acid
  • Piperacillin

Grants and funding

The authors have no support or funding to report.