In vitro antimicrobial activity, penetration rate into lung tissue, and therapeutic efficacy of tazobactam/piperacillin in the treatment of respiratory tract infections

Akira Watanabe, Hiroaki Kikuchi, Hiroshi Takahashi, Toshihiro Nukiwa, Yoshihiro Honda, Yutaka Tokue, Masakichi Motomiya, Satoru Shoji, Tsuneo Sayama, Yoshiyuki Anzai

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    2 Citations (Scopus)

    Abstract

    We studied the in vitro antimicrobial activities and the penetration into lung tissue of tazobactam/piperacillin (TAZ/PIPC), a 4:1 mixture of piperacillin (PIPC) and tazobactam (TAZ), a new potent inhibitor of β-lactamase, for evaluation of the therapeutic efficacy of TAZ/PIPC in the treatment of respiratory tract infections. The minimum inhibitory concentrations (MICs) of TAZ/PIPC, PIPC alone and sulbactam/cefoperazone (SBT/CPZ) against a total of 158 strains consisting of eight different species including methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens and Pseudomonas aeruginosa, were determined by the micro-broth dilution method using the Dynatech MIC 2000 system. As shown by MICs, TAZ/PIPC was more active than PIPC and as active as SBT/CPZ against most of the species tested. TAZ and PIPC penetrated into the lung tissue in a ratio of 1: 3; the tissue-serum ratio of TAZ was 65% and that of PIPC was 50%, 30~165 min after 30 min drip infusion of 2.5 g of TAZ/PIPC. A daily dose of 2.5 g (2 cases), 5.0 g (8 cases) or 7.5 g (5 cases) of TAZ/PIPC was given to a total of 15 patients for 8 to 21 days (mean: 13.9 days): seven with acute pneumonia, two with lung abscess, five with secondary infection in association with bronchiectasis and one with diffuse panbronchiolitis. The clinical effects were excellent in three, good in nine, fair in two and poor in one (efficacy rate: 80.0%). Ten strains were identified as causative organisms: three strains of Streptococcus pneumoniae, four strains of H. influenzae, two strains of P. aeruginosa, and one strain of K. pneumoniae. All of them were eradicated by treatment with TAZ/PIPC. Eosinophilia, transient elevation of transaminase, leukocytopenia and positive Coombs' test were observed in one patient each. All of these disappeared after the completion of therapy. From the above results, we conclude that TAZ/PIPC is a useful antibiotic for parenteral use as a first choice agent in the treatment of respiratory tract infections.

    Original languageEnglish
    Pages (from-to)332-345
    Number of pages14
    JournalChemotherapy
    Volume42
    DOIs
    Publication statusPublished - 1994 Jan 1

    Keywords

    • tazobactam/piperacillin

    ASJC Scopus subject areas

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

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