Clinical effectiveness of cefoperazone-sulbactam vs. piperacillin-tazobactam for the treatment of pneumonia in elderly patients

Chun Ta Huang, Chia Hung Chen, Wei Chih Chen, Yao Tung Wang, Chih Cheng Lai, Pin Kuei Fu, Li Kuo Kuo, Chin Ming Chen, Wen Feng Fang, Chih Yen Tu, Shih Chi Ku

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Objectives: Both cefoperazone-sulbactam (CFP-SUL) and piperacillin-tazobactam (PIP-TAZ) are β-lactam/β-lactamase inhibitor antibiotics and have a similar antimicrobial spectrum. However, comparative clinical efficacy and safety of CFP-SUL and PIP-TAZ for the treatment of pneumonia remain largely unknown, especially in elderly patients. Methods: Based on a multi-centre registry database, patients aged ≥65 years, diagnosed with severe community-acquired pneumonia (SCAP), hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP), and given empirical therapy with CFP-SUL or PIP-TAZ were included in the analysis. The primary outcome of interest was the proportion of patients achieving clinical cure. Multi-variate logistic regression was conducted to compare odds ratios (OR) for the outcome between patients who received CFP-SUL and patients who received PIP-TAZ. Results: In total, 941 elderly patients (624 with SCAP, and 317 with either HAP or VAP) were included in this study. Overall in-hospital mortality for the entire cohort was 19%. Clinical cure was achieved in 81% and 83% of patients with SCAP and HAP/VAP, respectively. Multi-variate logistic regression analysis showed similar odds for clinical cure for patients receiving CFP-SUL or PIP-TAZ among those with SCAP [adjusted OR 1.10, 95% confidence interval (CI) 0.71–1.70] or HAP/VAP (adjusted OR 0.72, 95% CI 0.30–1.76). Regarding safety, both CFP-SUL and PIP-TAZ were generally well tolerated with few reported adverse events. Conclusions: Among elderly patients with SCAP or HAP/VAP, empirical therapy with CFP-SUL is a viable alternative to PIP-TAZ, while considering antibiotic heterogeneity in the antimicrobial stewardship context.

Original languageEnglish
Article number106491
JournalInternational Journal of Antimicrobial Agents
Volume59
Issue number1
DOIs
Publication statusPublished - Jan 2022

Keywords

  • Adverse drug event
  • Cefoperazone-sulbactam
  • Outcome
  • Piperacillin-tazobactam
  • Pneumonia

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

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