Clinical Effects of Piperacillin and Tazobactam/Piperacillin on Haemophilus influenzae Lower Respiratory Tract Infection in Pediatric Patients

• Published in: Kansenshogaku Zasshi Vol. 79; no. 9; pp. 637 - 643
• Main Authors: KUROSAKI, Tomomichi, INAMI, Yukiko, TAKEDA, Nobue, SUDO, Fusayo, HOSHINO, Tadashi, FUKASAWA, Chie, HISHIKI, Haruka, ISHIWADA, Naruhiko, KOHNO, Yoichi
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japanese Association for Infectious Diseases 2005
• Subjects: Anti-Bacterial Agents - therapeutic use; bronchopulmonary infoctior; Child; Child, Preschool; Hacmophilus itfluenzae; Haemophilus Infections - drug therapy; Haemophilus influenzae; Humans; Infant; Penicillanic Acid - analogs & derivatives; Penicillanic Acid - therapeutic use; piperacillin; Piperacillin - therapeutic use; Piperacillin, Tazobactam Drug Combination; Respiratory Tract Infections - drug therapy; tazobactam piperacillin
• ISSN: 0387-5911; 1884-569X
• DOI: 10.11150/kansenshogakuzasshi1970.79.637

The prevalence of β-lactamase-nonproducing ampicillin-resistant (BLNAR) Hcxernophilus influenzae (H.influenzae) has been increasing in recellt years. Piperacillin (PIPC) is one of a few β-lactams possessing good activity against BLNAR H.influenzae We studied clillical efficacy of piperacillin and its β-lactamase inhibitor, tazobactam/piperacillin (TAZ PIPC) in children with lower respiratory tract infection caused by H. influenzae including resistance strains. Methods: Subjects were 20 children with lower respiratory tract infection caused by H. influenzae treated with PIPC 100mg kg day (7 cases) or TAZPIPC 125mg: kg/day (13 cases). We selected cases from which resistant H. influenzae strains might be detected. Patients received prior antimicrobial therapy within two weeks before admission, or with underlyhlg diseases. We exalllined patlellt profiles, clinical efficacy, susceptibilities for 6 β-lactam antibiotics [PIPC, TAZ PIPC. ampkillin (ABPC). cefotaxime (CTX). ceftriaxone (CTRX), and meropenem (MEPM)] and analyzed 6 genotype patterns of β-lactam resistant genes by PCR. Results: Efficacy was 7/7 in patients in PIPC group and 12/13 in patients in TAZ PIK: group. Diminished efficacy was seen in only one case complicated with severe RSV infection. The susceptibility of all strahls but one β-lactamase producing.ABPC resistant (BLP) strain to PIPC and of all to TAZ/ PIPC was below 0.25μg mL. The gellotype of the 15 strains isolated from the sputum on administration was as follows; β-ladamase nonproduclng, ABPC-susceptible (gBLNAS) strains were4, gBLP strain was 1, β-1actamase nonproducing. and ABPC-resistant (gLow-BLNAR) strains were 2.β-lactamase nonproducing, ABPC resistant (gBLNAR) strains were 8. Conclusion: PIPC and TAZ PIPC were useful against lower respiratory tract infection caused by H. influenzae including MA AR in children.