Premium
Antimicrobial Monotherapy versus Combination Therapy for the Treatment of Complicated Intra‐Abdominal Infections
Author(s) -
Petite Sarah E.,
Bauer Seth R.,
Bollinger Jessica E.,
Ahrens Christine L.,
Harinstein Lisa M.
Publication year - 2016
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1847
Subject(s) - antimicrobial , medicine , combination therapy , microbiology and biotechnology , biology
Study Objective It is unknown if β‐lactam monotherapy is sufficient for complicated intra‐abdominal infections or if broader coverage is required, such as with vancomycin. This study sought to determine the clinical outcomes of piperacillin/tazobactam (PIP/TAZ) monotherapy compared to combination therapy with vancomycin and PIP/TAZ for complicated intra‐abdominal infections among patients within a surgical intensive care unit (ICU). Design Retrospective cohort study. Setting Three surgical ICUs at a tertiary academic medical center. Patients Four hundred seventeen patients with a secondary peritonitis identified by International Classification of Diseases, Ninth Revision codes who received either PIP/TAZ monotherapy (228 patients) or PIP/TAZ and vancomycin combination therapy (189 patients). Measurements and Main Results The primary outcome was day 28 clinical cure; secondary outcomes included day 7 clinical cure, length of stay ( LOS ), and mortality. There were no statistically significant differences between the monotherapy and combination therapy groups with respect to day 28 clinical cure (33.9% vs 25.5%, p=0.064), day 7 clinical cure (23.6% vs 17.6%, p=0.14), or 28‐day mortality (7% vs 7.9%, p=0.72). LOS in the ICU was significantly shorter in the monotherapy group (6 days) compared with the combination therapy group (7 days; p=0.04); however, hospital LOS was not significantly different. Conclusions No difference was observed in clinical cure rates at day 28 or day 7 between those who received PIP / TAZ monotherapy compared to PIP / TAZ and vancomycin combination therapy.