Nosocomial Pneumonia Clinical Trial
Official title:
Optimizing Dosing Regimen of Piperacillin/Tazobactam, Prolonged Infusion vs. Regular Infusion, Every 6 Hours, for Nosocomial Pneumonia in ICU Caused by Susceptible Pathogens With Higher MIC
1. To observe clinical and bacteriologic responses of different regimens of
piperacillin/tazobactam (4.5g q6h, prolonged or intermittent infusion) for treatment of
nosocomial pneumonia.
2. To describe the pharmacokinetic profile of piperacillin/tazobactam (4.5g q6h, prolonged
or intermittent infusion) in patients with nosocomial pneumonia.
3. To assess the safety profiles of piperacillin/tazobactam 4.5g q6h, prolonged or
intermittent infusion in patients with nosocomial pneumonia.
Status | Recruiting |
Enrollment | 50 |
Est. completion date | December 2016 |
Est. primary completion date | November 2016 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 70 Years |
Eligibility |
Inclusion Criteria: 1. Male or female, aged 18 to 70 years old. 2. Inpatients with nosocomial pneumonia or bacteremia. i. Diagnosis of nosocomial pneumonia 1. Chest radiographic infiltrate that is new or progressive. 2. At least two or more of the following clinical findings suggesting infection. - New onset of fever, oral temperature T>38.3? or T<36? - Purulent sputum - WBC > 12×10^9/L or <4×10^9/L, or band form >10% - PaO2/FIO2<240mmHg ii. Diagnosis of bacteremia: Positive blood culture and the isolated bacterial strain are considered to be infection cause. 3. Patients are infected by piperacillin-tazobactam susceptible pathogen with MIC=4, 8 or 16mg/L. Exclusion Criteria: 1. The patients who received systematic antibacterial treatment more than 48 hours before enrollment and have clinical response. 2. Severe pyemia with hypotension or/and evidences of failure of organic function (shock: systolic pressure < 90mmHg or diastolic pressure < 60mmHg, requiring more than 4 hours of administration of vasopressor(s);renal impairment: urine volume < 20 ml/h or < 80 ml/4h after excluded any other potentials, acute renal failure need dialysis, CLcr<40 mL/min). 3. Documented infection caused by pathogens beyond the antibacterial spectrum of piperacillin/tazobactam. 4. Previously diagnosed condition which tend to mimic or complicate the course and evaluation of the infectious process, e.g. bronchial obstruction, obstructive pneumonia, activate pulmonary malignancy, pulmonary abscess, empyema and active tuberculosis, which might interfere the course of the infectious disease and evaluation of the disease. 5. History of allergy to penicillins. 6. Pregnancy or breast-feeding women. 7. Any conditions investigator considered might increase the risk of patients or interfere study results. |
Allocation: Randomized, Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
China | TianjinCIH | Tianjin | Tianjin |
China | TianjinCIH | Tianjin | Tianjin |
Lead Sponsor | Collaborator |
---|---|
Tianjin Medical University Cancer Institute and Hospital | Pfizer |
China,
Lorente L, Jiménez A, Martín MM, Iribarren JL, Jiménez JJ, Mora ML. Clinical cure of ventilator-associated pneumonia treated with piperacillin/tazobactam administered by continuous or intermittent infusion. Int J Antimicrob Agents. 2009 May;33(5):464-8. doi: 10.1016/j.ijantimicag.2008.10.025. Epub 2009 Jan 15. — View Citation
Roberts JA, Kirkpatrick CM, Roberts MS, Dalley AJ, Lipman J. First-dose and steady-state population pharmacokinetics and pharmacodynamics of piperacillin by continuous or intermittent dosing in critically ill patients with sepsis. Int J Antimicrob Agents. 2010 Feb;35(2):156-63. doi: 10.1016/j.ijantimicag.2009.10.008. Epub 2009 Dec 16. — View Citation
Wang H, Chen M, Ni Y, Liu Y, Sun H, Yu Y, Yu X, Mei Y, Liu M, Sun Z, Chu Y, Hu Z, Huang X. Antimicrobial resistance among clinical isolates from the Chinese Meropenem Surveillance Study (CMSS), 2003-2008. Int J Antimicrob Agents. 2010 Mar;35(3):227-34. doi: 10.1016/j.ijantimicag.2009.11.010. Epub 2010 Jan 4. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Extension of the Piperacillin / tazobactam infusion time effect evaluation | To observe clinical and bacteriologic responses of different regimens of piperacillin/tazobactam (4.5g q6h, prolonged or intermittent infusion) for treatment of nosocomial pneumonia. | 2 weeks | Yes |
Secondary | Reducing antibiotic resistance | To describe the pharmacokinetic profile of piperacillin/tazobactam (4.5g q6h, prolonged or intermittent infusion) in patients with nosocomial pneumonia. | 2 weeks | Yes |
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