Prospective randomized comparison study of piperacillin/tazobactam and meropenem
for healthcare-associated pneumonia in Japan.
Author(s): Yamamoto Y(1), Izumikawa K, Morinaga Y, Nakamura S, Kurihara S, Imamura Y,
Miyazaki T, Tsukamoto M, Kakeya H, Yanagihara K, Yasuoka A, Kohno S.
Affiliation(s): Author information:
(1)Department of Molecular Microbiology and Immunology, Graduate School of
Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan.
yamamoto@med.u-toyama.ac.jp
Publication date & source: 2013, J Infect Chemother. , 19(2):291-8
Healthcare-associated pneumonia (HCAP) may have a more severe course than
community-acquired pneumonia (CAP); hence, it is more likely to be caused by
drug-resistant bacterial pathogens and anaerobes involved in aspiration
pneumonia. We compared the efficacy and safety of initial empiric therapy with
piperacillin/tazobactam (PIPC/TAZ, 13.5 g/day) with that of meropenem (MEPM,
1.5 g/day) as single broad-spectrum regimens with gram-negative and anaerobic
coverage in patients with HCAP in Japan. The clinical cure rate was 75.9 % (22/29
cases) in the PIPC/TAZ group and 64.3 % (18/28 cases) in the MEPM group. The
clinical efficacy rate was 87.9 % (29/33 cases) in the PIPC/TAZ group and 74.2 %
(23/31 cases) in the MEPM group. The bacteriological eradication rate was 94.4 %
(17/18) in the PIPC/TAZ group and 87.5 % (14/16) in the MEPM group. Adverse drug
reactions were seen in 22.4 % (11/49 cases) of patients in the PIPC/TAZ group and
17.4 % (8/46 cases) of patients in the MEPM group. Although not statistically
different, the PIPC/TAZ group had a slightly higher efficacy rate than the MEPM
group. Both treatment regimens are tolerable and might be appropriate to use as
initial empiric therapy for HCAP in Japan. To investigate the differences in
efficacy profiles of those two regimens, a further confirmatory study with a
larger cohort as determined by a power analysis is recommended.
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