Clinical Efficacy and Pharmacoeconomics of a Continuous‐Infusion Piperacillin‐Tazobactam Program in a Large Community Teaching Hospital

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Abstract
Study Objective. To compare continuous versus intermittent administration of piperacillin‐tazobactam with regard to clinical, microbiologic, and economic outcomes.Design. Prospective, open‐label controlled study.Setting. Community teaching hospital.Patients. Ninety‐eight hospitalized patients prescribed piperacillintazobactam.Intervention. Substitutions were implemented so that 47 patients initially prescribed intermittent infusion of piperacillin‐tazobactam were switched to continuous infusion of this drug combination. Dosages varied in accordance with the type of infection and each patient's renal function. Fifty‐one other patients with similar demographics and types of infection received intermittent infusion with piperacillin‐tazobactam.Measurements and Main Results. Clinical success rates were 94% for the continuous‐infusion group and 82% for the intermittent‐infusion group (p=0.081). Microbiologic success rates were 89% for the continuous‐infusion group and 73% for the intermittent‐infusion group (p=0.092). Days to normalization of fever were significantly lower (p=0.012) in the continuous‐infusion group (1.2 ± 0.8 days) than in the intermittent‐infusion group (2.4 ± 1.5 days). Level 1 and level 2 costs/patient were both reduced by continuous infusion, although the difference was statistically significant only for level 2 costs ($399.38 ± 407.22 for continuous infusion vs $523.49 ± 526.85 for intermittent infusion, p=0.028).Conclusion. Continuous infusion of piperacillin‐tazobactam provided clinical and microbiologic outcomes equivalent to those for intermittent infusion. Compared with intermittent infusion, continuous infusion significantly shortened the time to temperature normalization, while also offering a significant reduction in level 2 expenditures.