[Piperacillin: Use in a general hospital]

Aim: To analyze the use of piperacillin in a general hospital in 1996 and 1997. Material and methods: The data from 338 patients who were treated with piperacillin between January 1996 and December 1997 were collected retrospectively. Results: We analyzed 385 infectious episodes in 338 patients with a mean age of 63.1 years. The therapeutic indications included nosocomial infection, infection in neutrophenic patients and other diagnoses such as respiratory, intraabdominal and osteoarticular infections. In most episodes, there were infections in neutrophenic patients, representing 39.2% of all cases. In 86.2% of the episodes the combination of piperacillin and aminoglycoside was established. The mean duration of the treatment with piperacillin was 8.9 days. Positive cultures were presented in 39.7% of the episodes. The microorganisms most frequently isolated were the Gram-negative bacilli, such as Pseudomonas aeruginosa and Escherichia coli. The isolations were obtained from sputum (24.6%), blood (22.1%), urine (19.8) and exudate (8.8%). The activity of piperacillin and aminoglycoside was 93% and 90% respectively against P. aeruginosa. The global mortality of the series was 25.5% with 18.9% being related to the infectious episode. Conclusions: From the above analyses we can deduce that piperacillin maintains its indications in a general hospital, these being, basically, neutrophenic infection and nosocomial pneumonia. Another indication is infection by Pseudomonas, against which it continues to show good activity.