Combination therapy of piperacillin with aminoglycosides in intractable respiratory tract infections

Rinzo Soejima, Yoshihito Niki, Masatoshi Watanabe, Chikara Nakahama, Jiro Hino, Akira Suzuki, Tugutami Onodera, Kazuo Takebe, Toyoichi Tamura, Katsumi Endo, Masato Hayashi, Masashi Tamura, Masuo Sato, Kiyoshi Konno, Kotaro Oizumi, Akira Watanabe, Izumi Hayashi, Kikuo Ohnuma, Tugushi Itoh, Fusanosuke YamasakuYasutoshi Suzuki, Osamu Sekine, Nobuki Aoki, Yukio Oki, Takashi Yokose, Toshio Fukui, Masataka Katsu, Junzaburo Kabe, Hiroyuki Kobayashi, Shin Kawai, Hiroshi Oshitani, Hiroshi Miura, Yoshio Kobayashi, Ippei Fujimori, Takao Ohkubo, Akira Ito, Shigeki Odagiri, Kaneo Suzuki, Kou Murohashi, Hiroshi Takahashi, Tsutomu Fukuda, Yasuhiko Ashikari, Masahito Kato, Toshihiko Takeuchi, Joichi Kato, Nobuhiro Narita, Masayoshi Sawaki, Keiichi Mikasa, Shigenori Nakajima, Koichi Fukuyama, Yoriko Tsuji, Tsuyoshi Okumoto, Ryo Kimura, Syunji Imanaka, Eiro Tsubura, Shinya Tada, Ikuro Kimura, Toshiharu Matsushima, Hirotane Ikeda, Yoshihiko Tano, Takao Sasaki, Yukio Matsumoto, Yuji Sugimoto, Osamu Kurimura, Hideo Sasaki, Hirofumi Fukuhara, Mariko Okada, Kazutaka Nishimura, Minoru Yoshida, Takamichi Aritomi, Hozumi Yamada, Osamu Kato, Kohei Hara, Masaki Hirota, Keizo Yamaguchi, Shigeru Kouno, Toshiaki Hayashi, Akira Yasuoka, Kazuo Sasayama, Tuneo Tutumi, Kouta Kouno, Yasuko Ueda, Kiyo Fujita, Keizo Matsumoto, Masaru Nasu, Jun Goto, Youichirou Goto, Hideaki Shigeno, Takayoshi Tashiro, Moritaka Suga, Masayuki Ando, Shukuro Araki, Kiyoshi Shima, Shinobu Takenaka, Koichiro Fukuda, Atsushi Saito, Yoshiteru Shigeno, Kenji Mori, Yuei Irabu

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Since combined use of piperacillin (PIPC) and aminoglycosides (AGs) shows a synergistic effectin vitro, a clinical examination of this combination therapy was carried out from August 1985 to January 1987 by a well controlled study. Drugs were administered at 4 g daily of PIPC alone, 120 mg of tobramycin (TOB) combined with 4 g of PIPC, or 200mg netilmicin (NTL) combined with 4 g of PIPC. 1. The clinical efficacy rates in all cases evaluated by the attending committee members were 66.0 in PIPC alone, 73.3% in PIPC combined with TOB, and 71.7% in PIPC combined with NTL, respectively. No significant difference was observed between PIPC alone and PIPC combined with AGs. There was also no significant difference in clinical effect between PIPC alone and PIPC combined with AGs evaluated by the committee members, in patients with pneumonia or pulmonary suppuration, and with chronic respiratory tract infection. 2. Bacteriological respose against causative organisms in all cases tends to be significantly superior in PIPC combined with AGs than in single use of PIPC. Particularly in infections due to Pseudomonas aeruginosa, the eradication rate was much superior. 20% in PIPC alone but 56% in PIPC combined with AGs. 3. There was no significant difference between PIPC alone and combined PIPC with regard to side effects or abnormality in laboratory findings. 4. There was no significant difference in usefulness between single use of PIPC and combined PIPC as evaluated by the committee members. In conclusion, we consider that combination therapy of PIPC with AGs was more effective than PIPC alone, particularly in treating chronic respiratory tract infections due to P. aeruginosa, and was just as safe.

    Original languageEnglish
    Pages (from-to)55-71
    Number of pages17
    JournalChemotherapy
    Volume36
    DOIs
    Publication statusPublished - 1988

    Keywords

    • Aminoglycosides
    • Piperacillin

    ASJC Scopus subject areas

    • Pharmacology (medical)
    • Infectious Diseases
    • Pharmacology
    • Drug Discovery
    • Oncology

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