Nationwide, multicenter survey on the efficacy and safety of piperacillin for adult community-acquired pneumonia inJapan

A survey on adult community-acquired pneumonia was conducted jointly by multiple centers nationwide to verify theJapanese Respiratory Society Guidelines for the Management of Community-Acquired Pneumonia in Adults (JRS2005). The efficacyand safety of piperacillin (PIPC) were investigated at the same time. PIPC is recommended as the initial treatment forpatients with suspected bacterial pneumonia and pneumococcal pneumonia in JRS2005. Overall, 552 and 333 patients wereregistered for safety and efficacy analysis in this study, respectively. The majority of the cases in which PIPC was used hadmoderate disease (63.7 %), and the most common daily dosage was 4 g (73.6 %). The efficacy rate was 83.5 % overall, 81.1 % inpatients with suspected bacterial pneumonia, and 92.8 % in patients with pneumococcal pneumonia. The efficacy rate with adaily dosage of 4 g was 84.9 %, and the efficacy rates achieved with a daily dosage of 4 g in patients who had mild andmoderate suspected bacterial pneumonia were 90.0 and 82.6 %, respectively. The most commonly isolated causative organismswere Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae), and the bacterial eradication rateswere high (97.2 and 100 %, respectively). The incidence of adverse drug reactions was 5.62 %, among which the main eventswere hepatic dysfunction and decreased white blood cell count. In conclusion, this study showed that PIPC is safe andeffective at 4 g/day for mild-to-moderate adult community-acquired pneumonia.