Treatment of ventilator-associated pneumonia with piperacillin-tazobactum and amikacin vs cefepime and levofloxacin: A randomized prospective study
- 1 July 2007
- journal article
- research article
- Published by Jaypee Brothers Medical Publishing in Indian Journal of Critical Care Medicine
- Vol. 11 (3), 117-121
- https://doi.org/10.4103/0972-5229.35084
Abstract
Study Objectives: To compare the survival benefits and cost effectiveness of cefepime-levofloxacin (C-L) as an alternative empirical antibiotic therapy for ventilator associated pneumonia (VAP) with the most widely recommended combination of piperacillin-tazobactam and amikacin (P-T-A). Design: Prospective, observational, cohort study. Materials and Methods: A total number of 879 patients were admitted in the ICU during 1st April 2004 to 31 st March 2005 and were screened for the study. Ninety-three patients were clinically suspected to develop early onset VAP. The patients were randomly divided into two groups receiving Cefepime-Levofloxacin (C-L) or Piperacillin-Tazobactam-Amikacin (P-T-A) as empirical antibiotic therapy. Treatment outcome was compared between the groups, which included ICU mortality, duration of mechanical ventilation, duration of ICU stay and total cost incurred on antibiotics. Results: The epidemiological characteristics including mean age and APACHE II score were comparable between the two groups. The mortality rates in the two groups were similar. The duration of mechanical ventilation was shorter in C-L group (5-8 days) as compared to P-T-A group (6-11 days). Also, the mean duration of ICU stay was reduced in C-L group (16Keywords
This publication has 16 references indexed in Scilit:
- Variability in Antibiotic Prescribing Patterns and Outcomes in Patients With Clinically Suspected Ventilator-Associated PneumoniaSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2003
- Evaluation of the in vitro activity of six broad-spectrum β-lactam antimicrobial agents tested against recent clinical isolates from India: a survey of ten medical center laboratoriesDiagnostic Microbiology and Infectious Disease, 2002
- Synergic activity of cephalosporins plus fluoroquinolones against Pseudomonas aeruginosa with resistance to one or both drugsJournal of Antimicrobial Chemotherapy, 2002
- Rotation and Restricted Use of Antibiotics in a Medical Intensive Care UnitAmerican Journal of Respiratory and Critical Care Medicine, 2000
- Inadequate Antimicrobial Treatment of InfectionsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1999
- Effect of ventilator-associated pneumonia on mortality and morbidity.American Journal of Respiratory and Critical Care Medicine, 1996
- Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unitIntensive Care Medicine, 1996
- Treatment of severe pneumonia in hospitalized patients: results of a multicenter, randomized, double-blind trial comparing intravenous ciprofloxacin with imipenem-cilastatin. The Severe Pneumonia Study GroupAntimicrobial Agents and Chemotherapy, 1994
- Incidence, Etiology, and Outcome of Nosocomial Pneumonia in Mechanically Ventilated PatientsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1991
- Antibiotic Misuse in Two Clinical Situations: Positive Blood Culture and Administration of AminoglycosidesClinical Infectious Diseases, 1991