Piperacillin: A review of clinical experience

Gooding, P. G.; Clark, Bradley; Sathe, Sunil

doi:10.1093/jac/9.suppl_b.93

Cited by 18 publications

(11 citation statements)

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“…It is of particular interest for treatment of complicated urinary tract infection because of its superior coverage of aerobic gram-negative bacilli, notably the Klebsiella species, the indole-positive Proteus species, some strains of Serratia marcescens and P. aeru ginosa [11]. In addition, it is as effective as penicillin G against group D streptococci [3], is synergistic with ami noglycosides, and has successfully eradicated carbcnicillin-resistant organisms in some cases [4].…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of piperacillin for complicated urinary tract infections is poorly documented and difficult to evaluate due to: lack of a controlled, randomized study design [12][13][14][15][16][17], mixed patient samples of complicated and uncomplicated infections (which probably would re spond just as well to oral antibiotic treatment) [4,13,17], and varying criteria for evaluation of bacterial response.…”

Section: Discussionmentioning

confidence: 99%

“…Bacterial persistence or relapse is common despite treatment [4,9,13,18], (2) The rate of superinfection is not decreased with piperacillin when directly compared to carbenicillin, which has a narrower in vitro spectrum. The develop ment of superinfection appears to be related more to pre vious antibiotic treatment and abnormalities of the geni tourinary tract, than to the spectrum of the penicillin [15].…”

Section: Discussionmentioning

confidence: 99%

“…Finally, it has been suggested that piperacillin may be less hepatotoxic [4], cause fewer bleeding complications [5], and induce hypokalemia less frequently than carbenicillin or ticarciliin.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Efficacy of Piperacillin versus Carbenicillin for Complicated Urinary Tract Infections

Sharifi¹,

Lee

Ojeda

1984

Urol Int

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In this controlled, randomized clinical trial we compared piperacillin and carbenicillin in the treatment of complicated urinary tract infections. 24 patients received piperacillin 150 mg/kg/day for 7.2 ± 2.75 days and 17 patients received carbenicillin 200 mg/kg/day for 7.5 ± 2.90 days. Patients were evaluated for clinical and bacteriologic responses and tolerance to therapy. Although the clinical cure rate significantly favored carbenicillin treatment (p < 0.01), the sum of the percentages of cases with clinical cure and clinical improvement were similar between groups: 91.6% for piperacillin and 88.2% for carbenicillin. The bacteriologic cure rates for piperacillin and carbenicillin patients (54.1 and 47.0%, respectively) were not significantly different (p > 0.05). The low cure rates in our study were probably the result of uncorrected/uncorrectable genitourinary tract abnormalities. Superinfections developed in 12.5 and 17.6% of piperacillin and carbenicillin patients, respectively, and were due to Klebsiella pneumonia, Proteus mirabilis, Citrobacter diversus, and Pseudomonas aeruginosa. Overall, side effects were mild, reversible, and did not require discontinuation of treatment. However, carbenicillin caused elevations in liver enzymes more frequently than piperacillin (p < 0.05). Based on our data, we recommend reserving piperacillin monotherapy for patients who are poor candidates for aminoglycosides, or are on severe sodium restriction, and have serious complicated urinary tract infections due to susceptible organisms. We do not recommend piperacillin alone for empiric treatment of complicated urinary tract infections.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparative Efficacy of Piperacillin versus Carbenicillin for Complicated Urinary Tract Infections

Sharifi¹,

Lee

Ojeda

1984

Urol Int

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“…PIPC has been shown to be safe and well tolerated. Overall, most of its adverse effects were limited to allergic reactions and gastrointestinal disturbance (1)(2)(3). There has been no previous report on DIC due to delayed hypersensitivity to PIPC.…”

Section: Introductionmentioning

confidence: 99%

Hypercoagulopathy with Piperacillin Administration in Osteomyelitis.

et al. 2000

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A 51-year-old man with osteomyelitis developed acute renal failure and superior mesenteric venous (SMV)thrombosis after piperacillin (PIPC) treatment. Coagulation profile disclosed disseminated intravascular coagulation (DIC). The serum levels of IgE and eosinophil cationic protein showed significant increases, while a lymphocyte stimulation test with PIPC also demonstrated an extremely high index. These observations suggest that hypersensitivity to PIPC might play a role in the pathogenesis of acute renal failure and SMVthrombosis due to hypercoagulopathy. Withdrawal of PIPC and anticoagulation therapy resulted in clinical improvementand normalization of the affected laboratory data. This is the first report to describe PIPCinduced hypercoagulopathy.

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Efficacy, safety, and tolerance of piperacillin/tazobactam compared to co-amoxiclav plus an aminoglycoside in the treatment of severe pneumonia

Speich

Imhof

Vogt

et al. 1998

Eur. J. Clin. Microbiol. Infect. Dis.

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An open, randomized, multicenter study was conducted to compare the efficacy and safety of piperacillin/tazobactam and co-amoxiclav plus aminoglycoside in the treatment of hospitalized patients with severe community-acquired or nosocomial pneumonia. Of the 89 patients who entered the study, 84 (94%) were clinically evaluable. A favorable clinical response was observed in 90% of the piperacillin/ tazobactam group and in 84% of the co-amoxiclav/aminoglycoside group (not significant). The bacteriological efficacy was comparable in both groups (96% vs. 92%; not significant). There was only one fatal outcome in the piperacillin/tazobactam group compared to six in the co-amoxiclav/aminoglycoside group regimen (P=0.058). The adverse event rate was non-significantly lower in the piperacillin/ tazobactam group compared to the co-amoxiclav/aminoglycoside group (2% vs. 7%; P= 0.32). Piperacillin/tazobactam is safe and highly efficacious in the treatment of serious pneumonia in hospitalized patients. It compares favorably with the combination of co-amoxiclav/aminoglycoside.

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Piperacillin: A review of clinical experience

Cited by 18 publications

References 0 publications

Comparative Efficacy of Piperacillin versus Carbenicillin for Complicated Urinary Tract Infections

Comparative Efficacy of Piperacillin versus Carbenicillin for Complicated Urinary Tract Infections

Hypercoagulopathy with Piperacillin Administration in Osteomyelitis.

Efficacy, safety, and tolerance of piperacillin/tazobactam compared to co-amoxiclav plus an aminoglycoside in the treatment of severe pneumonia

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