A Community Hospital Antimicrobial Stewardship Program’s Assessment of Prolonged Infusion Piperacillin-tazobactam for Pseudomonas Aeruginosa Pneumonia

Background: The study aim was to determine and compare the length of hospitalization, mortality, clinical stability, and time to clinical stability of a standard infusion (SI) and prolonged infusion (PI) piperacillin-tazobactam (TZP) in Pseudomonas aeruginosa ( PA) pneumonia patients. Methods: This retrospective study evaluated length of hospitalization, mortality, clinical stability, and time to clinical stability with either SI-TZP or PI-TZP therapy in hospitalized patients diagnosed with PA pneumonia between January 01, 2008 and June 30, 2014. Patients were included in the study if they received ≥2 days of TZP, were diagnosed with PA pneumonia, and had TZP therapy initiated within 3 days of the documented PA infection. Results: A similar proportion of patients achieved clinical stability between the PI (n=14, 70%) and SI (n=22, 67%) groups, (p=0.8). There was no statistically significant difference in the average time to clinical stability between the PI (mean=5.3±3.6) and SI (mean=5.8±6.8) groups, (p=0.77). The total length of stay in the PI group (mean=15.9±9.8) was shorter than in the SI group (mean=23.9±33) but did not achieve statistical significance, p=0.2. The 14-day all-cause mortality was similar between the two groups, PI (n=1, 5%) and SI (n=2, 6%). Conclusion: The use of PI TZP was equally effective as standard therapy. Further research is warranted to confirm these findings on the clinical benefits of prolonged infusion therapy