한국임상약학회지 (Korean Journal of Clinical Pharmacy)

  • 제28권3호
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  • Pages.167-173
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  • 2018
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  • 1226-6051(pISSN)
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  • 2508-786X(eISSN)
한국임상약학회 (Korean College Of Clinical Pharmacy)
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중환자실 내 병원성 폐렴 치료를 위한 Piperacillin/Tazobactam의 용량에 따른 효과와 안전성 비교

Comparison of Piperacillin/Tazobactam Dosing (13.5 g/day vs. 18 g/day) for the Treatment of Hospital-Acquired Pneumonia and Ventilator-associated Pneumonia in Intensive Care Unit

  • 강정은 (연세대학교의료원 세브란스병원 약무국) ;
  • 이경아 (연세대학교의료원 세브란스병원 약무국) ;
  • 김재송 (연세대학교의료원 세브란스병원 약무국) ;
  • 김수현 (연세대학교의료원 세브란스병원 약무국) ;
  • 손은선 (연세대학교의료원 세브란스병원 약무국)
  • Kang, Jeung Yun (Department of Pharmacy, Severance Hospital, Yon-sei University Health System) ;
  • Lee, Kyung A (Department of Pharmacy, Severance Hospital, Yon-sei University Health System) ;
  • Kim, Jae Song (Department of Pharmacy, Severance Hospital, Yon-sei University Health System) ;
  • Kim, Soo Hyun (Department of Pharmacy, Severance Hospital, Yon-sei University Health System) ;
  • Son, Eun Sun (Department of Pharmacy, Severance Hospital, Yon-sei University Health System)
  • 투고 : 2018.02.11
  • 심사 : 2018.05.22
  • 발행 : 2018.09.03
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초록

Background: In July 2016, the Infectious diseases society of america and the american thoracic society (IDSA & ATS) published a guideline recommending piperacillin/tazobactam (Pip/Tazo) 18 g/day as the anti-pseudomonal dose for the treatment of pathogenic pneumonia. After the guideline was published, the Pip/Tazo dose used for the treatment of pathogenic pneumonia was changed from 13.5 g/day to 18 g/day in a superior general hospital intensive care unit (ICU). In this study, we analyzed the effectiveness and safety of the new dose. Methods: Adult patients aged ${\geq}19years$ who were diagnosed with pneumonia in ICU and who received Pip/Tazo for 7 days or more from September 1, 2015 to May 31, 2017 were included in the study. The electronic medical record (EMR) was retrospectively analyzed. Results: At baseline, there was a significant difference between 44 patients treated with 13.5 g/day and 31 patients treated with 18 g/day of Pip/Tazo. The 18 g/day-treatment group comprised more elderly patients than the 13.5 g/day-treatment group (p=0.028). The results of the treatment-effects analysis showed no significant difference between the two groups. In case of safety data, there were significant differences in two parameters related to blood count, namely hemoglobin (p=0.016) and platelet count (p=0.011). Conclusion: Based on the significant difference in baseline age, there is a possibility that high-dose Pip/Tazo showed improved therapeutic effect. However, when high-dose Pip/Tazo was used, the blood cell count was found to drop from the reference value more frequently. Therefore, blood cell count should be monitored carefully when high-dose Pip/Tazo is administered.

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참고문헌

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