PIPERACILLIN TAZOBACTAM COMPARED WITH TICARCILLIN/CLAVULANATE IN COMMUNITY-ACQUIRED BACTERIAL LOWER RESPIRATORY-TRACT INFECTION/

The efficacy and safety of a new combination parenteral antibiotic, pi peracillin/tazobactam, was compared with that of parenteral ticarcilli n/clavulanate in the treatment of adult patients with community-acquir ed lower respiratory tract infections. A total of 299 patients were en rolled in this multicentre, double-blind, comparative study; 177 recei ved piperacillin/tazobactam and 122 received ticarcillin/clavulanate. Of these, 119 met the evaluability criteria (69, piperacillin/tazobact am and 50, ticarcillin/clavulanate). The study drugs (piperacillin/taz obactam 3 g/375 mg or ticarcillin/clavulanate 3 g/100 mg) were given e very 6 h by slow iv infusion for a minimum of 5 days. The favourable c linical response (cured and improved) rates of evaluable patients were 84% and 64% at endpoint (P < 0.01) for piperacillin/tazobactam and ti carcillin/clavulanate, respectively. The favourable bacteriological re sponse at the early follow-up (eradicated and presumed eradicated) wer e 91% and 67% for piperacillin/tazobactam and ticarcillin/clavulanate, respectively (P < 0.01). At endpoint, 84% and 64%, respectively (P = 0.02) had a favourable response. The most common adverse experiences i nvolved the gastrointestinal tract and occurred in 31.6% of the pipera cillin/tazobactam group compared with 20.5% in the ticarcillin/clavula nate group (P = 0.02). These events were mild and generally did not af fect therapy. Piperacillin/tazobactam appears to be more effective tha n ticarcillin/clavulanate in this patient population and is generally well tolerated.