[Clinical studies of tazobactam/piperacillin (TAZ/PIPC) in pediatric patients]
S Waga1, M Yokoyama, T Tsushima
1Department of Pediatrics, Hirosaki University School of Medicine.
Insights
Tazobactam/Piperacillin effectively treated pediatric infections caused by beta-lactamase-producing bacteria. This antibiotic combination demonstrated a 100% efficacy and eradication rate with minimal side effects in a small patient group.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Tazobactam/Piperacillin (TAZ/PIPC) is an intravenous antibiotic combining a beta-lactamase inhibitor (TAZ) with a beta-lactam antibiotic (PIPC).
- Beta-lactamase-producing bacteria pose a significant challenge in treating pediatric infections.
Purpose of the Study:
- To evaluate the clinical efficacy and pharmacokinetics of TAZ/PIPC in pediatric patients.
- To assess the effectiveness of TAZ/PIPC against beta-lactamase-producing pathogens.
Main Methods:
- A clinical evaluation of 14 pediatric patients with various infections.
- Pharmacokinetic analysis in 3 patients.
- Identification of causative pathogens and assessment of beta-lactamase production.
Main Results:
- 100% efficacy and bacteriological eradication rates were observed in all treated patients.
- TAZ/PIPC effectively eradicated beta-lactamase-producing E. coli and B. catarrhalis.
- Pharmacokinetic parameters in pediatric patients were comparable to adult data.
- Transient side effects, including diarrhea and nausea, were reported.
Conclusions:
- Tazobactam/Piperacillin is a useful therapeutic option for pediatric infections, particularly those caused by beta-lactamase-producing strains.
- The drug exhibits favorable efficacy and pharmacokinetic profiles in pediatric patients.
Abstract:
Tazobactam/Piperacillin (TAZ/PIPC) is a newly developed intravenous antibiotics, in which TAZ, a new potent inhibitor of beta-lactamases, is combined with PIPC, a well-established beta-lactam antibiotics, at the ratio of 1:4. In this study, we clinically evaluated efficacy of the drug in 14 pediatric patients with various infections, and pharmacokinetic study was applied to 3 patients. Range of age was from 1-month to 15 1/4-year. Patients consisted of 9 cases of pneumonia, 3 urinary tract infection, 1 acute otitis media, and 1 left sacroiliitis with sepsis. Standard dose of TAZ/PIPC was 50 mg/kg/dose and administered 2-4 times per day with intravenous injection or drip infusion. Two cases of pneumonia were excluded because of non-bacterial infection. Nine causative pathogens including 3 Gram-positive cocci and 6 Gram-negative bacilli were detected in 7 patients, of which 5 Gram-negative strains produced bete-lactamase. All of cases showed 100% of efficacy rate and bacteriological eradication rate. It was noted that beta-lactamase-producing E. coli and B. catarrhalis were eradicated efficiently by TAZ/PIPC, which should be resistant to PIPC alone according to MIC data. Non-serious diarrhea and discomfort of back with nausea were observed in one each patients as side effects. Both of side effects were transient, and improved with anti-diarrheic agent or cessation of the drug, respectively. As abnormal laboratory test results, moderate increases of the eosinophils and platelets counts as well as moderate elevation of the transaminases were observed in 2 separate patients. Pharmacokinetics study showed that Cmax, T1/2, and AUC were similar to the data reported in adult patients. Urinary recovery rate in the first 6 hours also resemble the data from adult patients. Based on above results, TAZ/PIPC is a useful agents pediatric infections by beta-lactamase producing strains also.
