I. Raad et al., Treatment of nosocomial postoperative pneumonia in cancer patients: A prospective randomized study, ANN SURG O, 8(2), 2001, pp. 179-186
Background: Nosocomial pneumonia continues to be associated with high morbi
dity and mortality in cancer patients.
Methods: In an attempt to find an optimal treatment for this infection, non
neutropenic cancer patients with postoperative nosocomial pneumonia were ra
ndomized to receive either piperacillin/ tazobactam (P/T) 4.5 g IV every 6
hours (30 patients) or clindamycin (Cl) 900 mg plus aztreonam (Az) 2 g IV e
very 8 hours (22 patients). Amikacin 500 mg IV every 12 hours was given to
all patients for the first 48 hours.
Results: The two groups were comparable for the characteristics of pneumoni
a that included Cram-negative etiology and duration of intubation. Response
rates were 83% for patients who received P/T and 86% for those who receive
d Cl/Az (P > .99). There were no serious adverse events; however, at our ce
nter the cost of the P/T regimen was $73.86 compared with $99.15 for the Cl
/Az regimen.
Conclusions: The two regimens had comparable high efficacy, and P/T had a s
light cost advantage. Either of these antibiotic regimens combined with an
aminoglycoside could lead to favorable outcome in cancer patients at high r
isk for nosocomial pneumonia.