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Piperacillin-Tazobactam Continuous Versus Intermittent Infusion for Pseudomonas Aeruginosa

Phase 3
Completed
Conditions
Pseudomonas Aeruginosa Infection
Interventions
Registration Number
NCT01577368
Lead Sponsor
Fundación Pública Andaluza para la gestión de la Investigación en Sevilla
Brief Summary

The main objective is to verify that the administration of piperacillin / tazobactam administered by continuous infusion to treat complicated infections or with known or suspected nosocomial isolation of Pseudomonas aeruginosa is superior in efficacy to a 30% higher dose administered in conventional short infusion.

The secondary objectives were compared between the following variables:

* Microbiological response at 3 days of starting treatment

* Time to microbiological cure

* Clinical response at 3 days of starting treatment

* Time to achieve defervescence

* To examine the relationship between pharmacokinetic variables and parameters of efficacy and safety

* To test the hypothesis that continuous infusion maintains adequate plasma drug levels compared with levels achieved with intermittent administration.

* Cost-effectiveness analysis

* Occurrence of adverse effects

To this end, we designed a multicenter, randomized, controlled, double blind, comparing both forms of administration in patients with complicated or nosocomial infection with or without isolation of Pseudomonas aeruginosa.

Patients who are candidates for inclusion are classified according to APACHE II and to have or not isolation of Pseudomonas aeruginosa. Subsequently be randomized to receive piperacillin-tazobactam by continuous infusion or short. Primary endpoint was measured as the ultimate effectiveness of treatment and other variables such as high efficiency, safety, pharmacokinetic and pharmacoeconomic.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
76
Inclusion Criteria
  • Complicated or Nosocomial Pseudomonas Aeruginosa Infection or Suspected Infection
  • > 18 years and > 40 kg
  • Negative pregnancy test for women within fertile period
  • Informed consent signature
Exclusion Criteria
  • Life expectancy < 72 hr
  • Central Nervous System (CNS) infection
  • Ventilator-associated pneumonia
  • Severe Neutropenia (<500 cells/ml)
  • Acinetobacter baumannii or extended spectrum beta lactamase (ESBL) suspected infection
  • Cystic fibrosis
  • Shock
  • Creatinine clearance < 20 ml/min
  • Dialysis or hemoperfusion

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Piperacillin continuous infusionPiperacillin-Tazobactam continuous infusionPiperacillin-Tazobactam 2gr (Loading dose DAY 1) plus Piperacillin-Tazobactam continuous infusion 8gr every 24 hours
Piperacillin intermittent infusionPiperacillin-Tazobactam intermittent infusionPiperacillin-Tazobactam 4gr intermittent infusion 4gr every 8 hours
Primary Outcome Measures
NameTimeMethod
Proportion of patients with satisfactory clinical response (cure or improvement) at the end of Piperacillin-Tazobactam treatment14 days

* Clinical cure: complete resolution of all signs and symptoms of infection

* Clinical improvement: resolution or improvement of most signs and symptoms of infection

Secondary Outcome Measures
NameTimeMethod
Mortality28 days
Proportion of patients with clinical response (cure or improvement) at 3 days3 days

* Clinical cure: complete resolution of all signs and symptoms of infection

* Clinical improvement: resolution or improvement of most signs and symptoms of infection

Proportion of patients with microbiological response3 days

- Microbiological response: bacteriological eradication of causative organisms

Proportion of patients with adverse effects14 days & 60 days
Time to defervescence14 days

- Time to the abatement of fever

Time to clinical cure14 days

Trial Locations

Locations (1)

Hospital Universitario Virgen del Rocío

🇪🇸

Seville, Spain

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