Evaluation of efficacy and safety of piperacillin for pneumonia and secondary infection with chronic respiratory disease

Shigeru Itabashi, Akira Watanabe, Mitsuo Kaku, Hiroaki Takeda, Katsunao Niitsuma, Kazuhiro Ozawa, Takashi Mouri, Kazutoshi Gomi, Yoshiyuki Nakai, Tatsuya Abe, Reiko Ono, Noboru Asou, Hiroshi Iga, Mitsunobu Homma, Hideki Ikeda, Sumito Inoue, Hiroshi Saito, Tomei Tsukamoto, Shunji Kaise, Shinsaku MaedaShuzo Suzuki, Yoshihiro Kazuta, Tatsuo Kawashima

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Piperacillin (PIPC) has excellent antibacterial activities against Streptococcus pneumoniae, including penicillin-resistant Streptococcus pneumoniae (PRSP), and Haemophilus influenzae, including beta-lactamase-negative, ampicillin-resistant Haemophilus influenzae (BLNAR). To demonstrate this clinically, we evaluated the clinical efficacy of PIPC on pneumonia and secondary infection with chronic respiratory disease in which S. pneumoniae or H. influenzae was considered a prophlogistic bacteria. We found that the clinical efficacy ratio was 98.4% in all patients, and disappearance of S. pneumoniae and H. influenzae was 92.9% and 95.8%, sufficiently fulfilling the intended purpose. Bacteriological efficacy was 96.9% in monomicrobial infection (S. pneumoniae: 100%, H. influenzae: 93.8%) and 84.2% in polymicrobial infection. Monomicrobial and polymicrobial infections became negative in 92.2%. When a patient was treated based on infection with S. pneumoniae or H. influenzae, even in mixed infection, sufficient clinical effect was obtained in those with or without mixed infection. The minimum inhibitory concentration (MIC) of PIPC for S. pneumoniae and H. influenzae isolated in this study was as follows: for S. pneumoniae, the range of MIC was ≤ 0.06-4 μg/mL and MIC90 was 4 μg/mL; and for H. influenzae, the range of MIC was ≤ 0.06-8 μg/mL and MIC90 was 0.25 μg/mL. The antibacterial activity against penicillin-intermediate S. pneumoniae (PISP), PRSP, and BLNAR was 4 μg/mL of MIC90 for PISP + PRSP and 0.25 μg/mL of MIC90 for BLNAR. PIPC is thus clinically effective against patients with pneumonia and (with) secondary infection in chronic respiratory disease by S. pneumoniae including PISP and PRSP, and H. influenzae including BLNAR. S. pneumoniae and H. influenzae are highly probable prophlogistic bacteria of community-acquired pneumonia and secondary infection in chronic respiratory disease. In view of this, PIPC should prove to be an appropriate antibacterial drug for empiric therapy for patients with community-acquired pneumonia and secondary infection in chronic respiratory disease.

Original languageEnglish
Pages (from-to)259-267
Number of pages9
JournalJapanese Journal of Chemotherapy
Volume53
Issue number4
Publication statusPublished - 2005 Apr

Keywords

  • BLNAR
  • Community-acquired pneumonia
  • Piperacillin
  • Post-marketing surveillance
  • Streptococcus pneumoniae

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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