Selection of piperacillin/tazobactam infusion mode guided by SOFA score in cancer patients with hospital-acquired pneumonia: a randomized controlled study

Abstract

Background

This study aimed to select piperacillin/tazobactam (TZP) infusion mode guided by Sequential Organ Failure Assessment (SOFA) score in cancer patients with hospital-acquired pneumonia (HAP) postoperation.

Patients and methods

A total of 120 cancer patients with postoperative HAP were divided into two groups: improved administration group (L group) and conventional treatment group (Con group). The Con group received traditional infusion of TZP and the L group received it as prolonged infusion. Blood drug concentration was detected at different time points. Based on the SOFA cut-off value of 9, the patients were regrouped into M (mild) and S (severe) groups.

Results

Percent time that the free drug concentrations remain above the minimum inhibitory concentration (%fT>MIC) was longer than 5 h in L group, but <4 h in Con group. Administration method (p=0.033, OX value 2.796, B value 1.028, 95% CI: 0.855–8.934) and SOFA score (p=0.038, OX value 0.080, B value −2.522, 95% CI: 0.007–0.874) were independent predictors of patient survival. In the S group, compared to conventional treatment, prolonged infusion mode resulted in shorter days of antibiotic use and shorter ventilator time, and achieved longer survival, better clinical efficacy, and lower 28-day mortality rate.

Conclusion

For cancer patients with SOFA score ≥9, prolonged infusion of TZP could benefit the patients and obtain better clinical efficacy.

Keywords:

• cancer
• Sequential Organ Failure Assessment score
• piperacillin
• tazobactam
• pneumonia
• antibiotics

Acknowledgments

The study was supported by a grant from the Science and Technology fund of Tianjin Municipal Health Bureau, China (No 2013KZ091) and the Science Foundation of Tianjin Medical University, China (No 2014KYQ10).

Disclosure

The authors report no conflicts of interest in this work.