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Titolo:
Piperacillin/tazobactam versus cefotaxime plus metronidazole for the treatment of severe intra-abdominal infection in hospitalized pediatric patients
Autore:
Adam, D; Linglof, T; Floret, D; Kirsch, T;
Indirizzi:
Univ Munich, Dr von Haunersches Childrens Hosp, Munich, Germany Univ Munich Munich Germany Haunersches Childrens Hosp, Munich, Germany Univ Hosp, Uppsala, Sweden Univ Hosp Uppsala SwedenUniv Hosp, Uppsala, Sweden Hop Edouard Herriot, Lyon, France Hop Edouard Herriot Lyon FranceHop Edouard Herriot, Lyon, France Wyeth Ayerst Res, Martinsried, Germany Wyeth Ayerst Res Martinsried Germany h Ayerst Res, Martinsried, Germany
Titolo Testata:
CURRENT THERAPEUTIC RESEARCH-CLINICAL AND EXPERIMENTAL
fascicolo: 6, volume: 62, anno: 2001,
pagine: 488 - 502
SICI:
0011-393X(200106)62:6<488:PVCPMF>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
RESPIRATORY-TRACT INFECTIONS; INTRAABDOMINAL INFECTIONS; IMIPENEM-CILASTATIN; MULTICENTERED TRIAL; TAZOBACTAM; RESISTANCE; THERAPY; COMBINATION; PNEUMONIA; TOLERANCE;
Keywords:
piperacillin/tazobactam; cefotaxime; metronidazole; intra-abdominal infection; pediatric;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Adam, D Univ Munich, Kinderklin, Linwurmerstr 4, D-80337 Munich, Germany Univ Munich Linwurmerstr 4 Munich Germany D-80337 Munich, Germany
Citazione:
D. Adam et al., "Piperacillin/tazobactam versus cefotaxime plus metronidazole for the treatment of severe intra-abdominal infection in hospitalized pediatric patients", CURR THER R, 62(6), 2001, pp. 488-502

Abstract

Background: Intra-abdominal infections (IAIs) are especially difficult to treat. Piperacillin/tazobactam (pip/tazo), a beta -lactam/beta -lactamase inhibitor combination, has been shown to be effective against intra-abdominal, gynecologic, and skin/soft tissue infections as well as infections of the lower respiratory and urinary tracts. Objective: The purpose of this study was to compare the efficacy of pip/tazo with that of cefotaxime plus metronidazole (cef + met) in pediatric patients with severe, complicated IAI. Methods: In this multinational, multicenter, randomized, open-label, parallel-group study, patients aged 2 to 12 years who were hospitalized for severe, complicated IAI were randomly assigned to receive infusions of pip/tazo(100 mg/kg piperacillin/12.5 mg/kg tazobactam) over 30 to 60 minutes every8 hours or cef + met (50 mg/kg cefotaxime plus 7.5 mg/kg metronidazole) over 30 minutes every 8 hours. The primary efficacy end point was clinical response (cure or failure) in the efficacy evaluable population at the end oftreatment and at follow-up, as assessed by an independent committee of reviewers who were blinded to treatment (the blinded evaluation committee [BEC]). Secondary end points were clinical response in the intent-to-treat population at the end of treatment and at follow-up as assessed by the investigators, and bacteriologic response in patients with an identified baseline pathogen. Results: Of the 545 patients enrolled in 46 centers, 402 were evaluable for efficacy (201 in each treatment group). Based on the BEC's assessment of clinical response, the cure rate was 93.5% in both groups at the end of treatment; at follow-up the cure rate was 90.0% in the pip/tazo group and 91.0% in the cef + met group. Success rates at the end of treatment in the intent-to-treat population, as assessed by the investigators, were similar to the cure rates found bythe BEC for the evaluable population - 87.8% in the pip/tazo group and 89.5% in the cef + met group. Clinical cure rates in patients who had an identifiable pathogen at baseline were > 80% for all pathogen species for which greater than or equal to 10 isolates were obtained, except for Pseudomonas species. Rates of bacteriologic success (eradication of all baseline pathogens, with no relapse or superinfection) in the pip/tazo and cef + met groups were similar at the end of treatment (90.1% and 91.0%, respectively) and at follow-up (88.2% and 89.7%, respectively). Adverse-event profiles and incidence rates were similar in the 2 treatment groups. Length of hospital stay was significantly shorter for patients treated withpip/tazo than for patients treated with cef + met (P less than or equal to0.011). Conclusion: Monotherapy with pip/tazo was as effective as combination treatment with cefotaxime plus metronidazole in children with severe, complicated IAI and should be considered when deciding on a first-line therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 19:57:04