Piperacillin: A review of clinical experience

Clinical studies have been conducted to assess the safety and efficacy of piperacillin in the treatment of patients with moderate to severe infections caused by susceptible bacteria. Efficacy data have been analysed from open studies involving 485 hospitalized patients treated with a total of 493 courses of piperacillin administered intravenously. In these patients, 885 organisms were considered to be causative in a total of 562 infections. The average age of the patients was 56 years; the average daily dosage of piperacillin was 13 g and treatment was given for an average of 11 days. A satisfactory clinical response, defined as cure and clinical improvement, was achieved in 90% of the infections, or 506 of the total of 562 infections treated. Eighty percent of the causative organisms were eradicated. Additional studies of piperacillin (136 patients) in comparison with carbenicillin or a combinination of carbenicillin and gentamicin (137 patients) were conducted also. Clinical and bacteriological results were not significantly different but there was a significantly lower incidence of adverse effects in the piperacillin treated patients. Piperacillin was shown to be safe and well tolerated. Overall, adverse effects were limited to hypersensitivity reactions in 4%, gastrointestinal intolerance in 3 and others 1%. Local tolerance was excellent, with phlebitis in only 4%, pain 1% and all other reactions 1%. A low incidence of changes in laboratory tests was observed also. The clinical studies demonstrate the efficacy and safety of piperacillin for the treatment of patients with infections at various sites caused by a broad range of pathogens.