Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Piperacillin”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1990

In vitro activity against clinically important gram-positive and gram-negative bacteria of sulbactam, alone and in combination with ampicillin, cefotaxime, mezlocillin, and piperacillin.

The in vitro effects of the single agents, and the synergistic/antagonistic action of three different combinations of ampicillin (AMP, CAS 69-53-4), cefotaxime (CTX, CAS 63527-52-6), mezlocillin (MEZ, CAS 51481-65-3), and piperacillin (PIP, CAS 61477-96-1) with the beta-lactamase inhibitor sulbactam (SUL, CAS 68373-14-8) were determined against 675 gram-positive and gram-negative, both aerobic and anaerobic bacteria. All the combinations of sulbactam and the antibiotics (1: 1, 1:2 and 1:4) exhibited very similar synergistic action. The percentage of the total strains tested for which synergistic activity was found was 51% with SUL + AMP (1:1), 24% with SUL + CTX (1:1), 31% with SUL + MEZ (1:1), and 28% with SUL + PIP (1:1). A fourfold or greater reduction of MIC's in the comparison with the antibiotics alone was found with 23% of the total strains tested for the SUL + AMP, with 9% of the strains tested with SUL + CTX, with 11% of the strains tested with SUL + MEZ, and with 15% of the strains tested with the SUL + PIP-combination. In the presence of sulbactam, 18% of the strains tested showed a significant reduction in the number of resistant strains with ampicillin, 7% with cefotaxime, 16% with mezlocillin, 14% with piperacillin, and in parallel there was an increase in the number of fully susceptible strains (shift from resistant or moderately sensitive to sensitive) by about 14%. In comparison with the antibiotic alone, the most marked reductions in the number of resistant strains on combination with sulbactam were as follows (the percentage of reduction is shown in brackets): for SUL + AMP and Acine-tobacter spp. (39% fewer resistant strains). Citrobacter spp. (-60%), Enterobacter aerogenes (-48%), Klebsiella oxytoca (-49%), Klebsiella pneumoniae (-63%), Morganella morganii (-74%), and Proteus vulgaris (-55%); for SUL + CTX and Acinetobacter spp. (-38%), Enterobacter cloacae (-6%), Klebsiella pneumoniae (-16%), Serratia marcescens (-9%), and Bacteroides fragilis (-31%); for SUL + MEZ and Acinetobacter spp. (-68%), Citrobacter spp. (-27%), Enterobacter spp. (-23%), Klebsiella pneumoniae (-32%), and Serratia marcescens (-19%); for SUL + PIP and Acinetobacter spp. (-41%), Citrobacter spp. (-30%), Klebsiella spp. (-30%), and Serratia marcescens (-33%).

Ampicillin↗
PubMed1990

[Treatment of aspiration pneumonia with piperacillin].

Clinical efficacy and safety of piperacillin were evaluated in 30 patients with a severe aspiration pneumonia admitted in our intensive care unit from july 1987 to december 1988. 20 women and 10 men (with a mean SAPS: 14) had a right pneumonia in 17 cases, left in 6, bilateral in 7 cases. A pathogen was isolated in 18 patients by protected distal catheterism, in 3 patients by blood cultures. 25 patients cured. However with a high isolation of Staphylococci it appears reasonable to associate piperacillin with an aminoglycoside before the obtention of bacteriological results.

Adult↗
PubMed1989

Bacteriolytic combination effect of cefminox and piperacillin evaluated by turbidimetry.

The bacteriolytic combination effect of cefminox (a potent bactericidal cephamycin) and piperacillin (a broad spectrum ureidopenicillin) was investigated using turbidimetry and expressed as a measure of the combination effect by the relative ratios of bacteriolytic area under the growth curves. Against 20 strains of Gram-positive and -negative bacteria, simultaneous treatment of both antibiotics showed synergy (five strains), indifference (15 strains) and no antagonistic effect. Pretreatment with piperacillin for 1 h followed by combined treatment with cefminox showed a profound enhancement of the bacteriolytic activity against 12 out of 20 strains, especially against Serratia, Enterobacter and Pseudomonas species. In contrast, pretreatment with cefminox against seven strains gave mainly an indifferent effect (four strains). The turbidimetric method gave results comparable with those obtained from the chequerboard method (FIC index), as far as Gram-positive and some of the Gram-negative bacteria (E. coli, K. pneumoniae, M. morganii) were concerned. For Serratia, Enterobacter and Pseudomonas sp., the turbidimetric method showed synergy or indifference in many cases, whereas the chequerboard method showed antagonism. Marked enhancement of lysis by the combination was ascribed at least partly to the D-amino acid side-chain of cefminox.

Bacteria↗
PubMed1986

[Piperacillin in in vitro-in vivo combination].

Launched two years ago, piperacillin is administered either alone or combined with other antibiotics. Broadening the antibacterial spectrum, looking for synergism and preventing the emergence of resistant mutants constitute a major preoccupation, especially in immunodepressed patients, and an indication for combined antibiotic therapy. The most effective combination, justified by in vitro tests, consists of a beta-lactam antibiotic and an aminoglycoside. In vitro studies have demonstrated an antagonistic effect between two beta-lactam antibiotics, and mutants have been isolated in vivo. The results obtained with the piperacillin-vancomycin combination are not as good as those obtained with previous combinations. The advent of new compounds, such as aztreonam, fluorinated quinolones and beta-lactamase inhibitors offers hopes of excellent results.

Aminoglycosides↗
PubMed1986

[Piperacillin in the newborn infant. A clinical and pharmacologic study].

The study involved 70 neonates born at 27 to 48 weeks of pregnancy (mean: 34.2 weeks) and weighing between 840 and 4350 g (mean: 1860 g). In every case piperacillin was combined with an aminoglycoside. The infants were treated for materno-foetal infection (14), post-partum infection (19), enterocolitis (18, surgical in 9 cases) and other post-operative infections (19). The antibiotic combination was given prophylactically in 2 cases. Fifty micro-organisms were isolated in 39 patients: 24 from blood (hemoculture), 2 from CSF, 24 from multiple peripheral samples. There were 13 Gram-positive organisms (Streptococcus B, D, A, Listeria spp.) and 37 Gram-negative organisms (E. coli 14, Klebsiella spp. 10, Enterobacter spp. 6). Clinical and bacteriological cure was obtained in 67 patients. Three failures were recorded, with resistance to treatment of Klebsiella pneumoniae and emergence (at hemoculture) of Klebsiella oxytoca under treatment in one patient and of Enterobacter cloacae in another patient. A pharmacokinetic study was performed in 47 neonates. Piperacillin (75 mg/kg per dose) was given twice a day until the 8th day post-partum and three times a day subsequently. The antibiotic was administered either by 30-min infusions or by intravenous or intramuscular injections; 124 serum level measurements were carried out at peak and/or residual level. In 44 infants with normal renal and hepatic function the mean residual level was 23 micrograms/ml (range: 7-100 micrograms/ml) and the mean peak level was 119 micrograms/ml (range: 47-278 micrograms/ml). No local or systemic side-effect was noted, and there was no evidence of toxicity.

Bacterial Infections↗
PubMed1986

[Piperacillin combined with netilmicin and cloxacillin. Usefulness in the treatment of febrile episodes in neutropenic children].

No preventive treatment other than intestinal decontamination with oral colimycin was given. Antibiotic therapy with piperacillin 200-300 mg/kg, netilmicin 6-7.5 mg/kg and cloxacillin 50-100 mg/kg was initiated within 6 to 12 hours of clinical onset, using a central catheter. Twenty-nine children with bone marrow aplasia and less than 1000 leucocytes/mm3 were treated: 20 had acute lymphoblastic leukaemia or lymphoma (first episode 13, relapse 7, including 3 undergoing bone marrow transplantation), 6 had acute myeloblastic leukaemia (first episode 4, relapse during transplantation 2), and there was 1 case each of idiopathic bone marrow aplasia, metastatic sympathico-blastoma and lymphohistiocytosis. Mean age was 9 years (range: 2-19 years). The combined antibiotic therapy was continued until recovery from aplasia in case of success and discontinued after 48 hours in case of failure. Bacteriological examinations were negative in 19 patients and positive in 10; 13 strains were isolated, mostly staphylococci and streptococci. Apyrexia was obtained in 24 patients, 11 of whom had a rise of temperature with negative bacteriology about 10 days later. There were 4 initial failures and one unassessable result. An atopic patient developed a skin rash on the 3rd day of treatment. There was no death, no superinfection and non clinical or biochemical side-effect. It is concluded that the piperacillin-netilmicin -cloxacillin combination, which gave a high success rate and was well tolerated, can be recommended in neutropenic children with febrile episodes.

Adolescent↗
PubMed1986

[Short-term antibiotic prophylaxis in colorectal surgery: cefoxitin versus piperacillin. A double-blind randomized study, 60 cases].

A randomized, double-blind comparative trial of cefoxitine and piperacillin was conducted in two groups of 30 patients with a similar number of the usual risk factors. Doses of cefoxitine 2 g and piperacillin 4 g were administered only once, except in some cases when the operation lasted more than 5 hours. Analysis of the results showed that the two antibiotics had equivalent prophylactic effectiveness (congruent to 6%) in colorectal surgery.

Abscess↗
PubMed1986

[In vitro inhibition of granulopoiesis by beta-lactam antibiotics. Comparison of piperacillin, mezlocillin, ceftriaxone and ceftazidime].

The mechanism of neutropenia induced by beta-lactam antibiotics was explored by studying the action of these drugs on granulopoiesis in vitro. Normal bone marrows were cultivated in the presence of increasing concentrations of piperacillin (10 marrows), mezlocillin, ceftriaxone and ceftazidime (5 marrows each) in order to find out whether these antibiotics exhibited toxicity to granulocyte-monocyte precursors. A dose-dependent inhibition of granulopoiesis was found in all cases. When the doses used were equivalent to maximum plasma concentrations in vivo, inhibition was minimal with piperacillin and mezlocillin and much more pronounced with the cephalosporins. This dose-dependent inhibition suggests that toxicity is involved in the mechanism of neutropenia induced by beta-lactam antibiotics.

Anti-Bacterial Agents↗
PubMed1987

Enterococci and aminoglycosides: evaluation of susceptibility and synergism of their combination with piperacillin.

Some clinical isolates of enterococci were tested for susceptibility to gentamicin, tobramycin, amikacin and netilmicin. Five percent of Streptococcus faecalis tested demonstrated high level resistance (minimum inhibitory concentration (MIC) greater than 2024 micrograms/ml) to gentamicin, tobramycin and netilmicin, while amikacin had MICs greater than 128 micrograms/ml for all strains tested. Since a combination of a beta-lactam and streptomycin does not produce synergism against all strains of enterococci for an increase in the number of highly resistant strains, the effect of piperacillin plus gentamicin, tobramycin, and netilmicin was examined. The combination piperacillin + netilmicin seemed to be very effective against all enterococci tested.

Aminoglycosides↗
PubMed1988

Penetration of clindamycin, cefoxitin, and piperacillin into pancreatic juice in man.

In our segmental pancreatic transplantation technique the pancreatic juice is temporarily diverted to the exterior via a pancreatic duct catheter. This permits studies on pure pancreatic juice to be carried out. In 11 such patients we studied the penetration of clindamycin, cefoxitin, and piperacillin into pancreatic juice. These three antibiotics all have good effect against the bacteria commonly isolated during pancreatic infections. Simultaneous blood and pancreatic juice samples were collected immediately before drug administration and at 30, 60, 90, and 120 minutes and 3, 4, 5, 6, and 8 hours after administration. The concentration of clindamycin in pancreatic juice was 34% of that in serum and exceeded the minimum inhibitory concentration for most bacteria associated with pancreatic infections. In spite of adequate serum concentrations of cefoxitin and piperacillin, the concentrations in pancreatic juice were only 8% and 5%, respectively, and did not exceed the minimum inhibitory concentration for the relevant bacteria. In view of these findings, clindamycin seems to be preferable in the treatment of pancreatic infections.

Adult↗
PubMed1985

[Bronchial diffusion of piperacillin in 18 intensive care patients].

Eighteen patients (13 under mechanical ventilation) in an intensive care unit received piperacillin for pneumonia (7 cases) or bronchial infection (11 cases), related to Haemophilus influenzae (7), Streptococcus pneumoniae (4) or miscellaneous pathogens (7) including Staphylococcus, E. coli, Klebsiella pneumoniae and Proteus mirabilis. Each patient was given 2g piperacillin intravenously every six hours. Concentrations in serum and bronchial secretion samples were assayed by the agar diffusion technique using a susceptible strain of Bacillus subtilis ATCC 6633. Maximum concentrations were 157 micrograms/ml in serum and 3.60 micrograms/ml in bronchial secretions. These results are similar to those obtained with the same dosage by 0. Cars in serum (150 micrograms/ml) and by G.E. Marlin in the bronchial secretions (3.78 micrograms/ml). They approximate those published for other penicillins with the same dosage.

Bacterial Infections↗
PubMed1985

A prospective double-blind comparison of piperacillin, cephalothin and cefoxitin in the prevention of postoperative infections in patients undergoing intra-abdominal operations.

Piperacillin has been shown to be as safe and effective an agent as cephalothin and cefoxitin when used in patients undergoing elective intra-abdominal surgical procedures. Enterococcus species have been shown in other studies to be susceptible to piperacillin, perhaps making it the preferred antibiotic for prophylaxis in clinical settings when enteric flora will be encountered.

Abdomen↗
PubMed1985

[Pulse polarographic determination of piperacillin (Pipril) in serum and urine].

Two pulse polarographical methods for determination of the half-synthetic penicillin derivate piperacillin in serum and in urine are described. 3.7 X 10(-5) mol/l (20 micrograms/ml) can yet been proved in serum with the direct pulse polarographical determination. 1.85 X 10(-6) mol/l (1 microgram/ml) can quantitatively be determined after preceded hydrolysis. Both the methods are diffusion standards being well developed which can be evaluated in an adequate manner. The piperacillin concentrations determined by pulse polarography agree to the levels of the agar diffusion test. The precision is some reduced by the separations incorporated. Inspite of the hydrolysis, the pulse polarographical method of determination will offer more prompt and reliable results.

Chromatography, Thin Layer↗
PubMed1986

[Clinical studies of efficacy of piperacillin against complicated urinary tract infections].

Clinical efficacy of piperacillin against 74 cases with complicated urinary tract infection was examined. Piperacillin was administered at the dose of 4 g (2 g twice daily) through intravenous drip infusion. The overall clinical value was rated in "excellent", in 9 cases, "moderate" in 34 cases and "poor" in 31 cases with a total efficacy of 58.1%. In the analysis of clinical values based on background, its efficacy was statistically significantly lower in the patients at a higher age, those with complication of diabetes mellitus, and those with indwelling catheter. In operated cases compared to non-operated cases, it was suggested to be more effective for improving the disturbances in urinary flow as a result of the removal of the underlying conditions by the operation. As to bacteriological efficacy, 64 out of 95 strains (67.4%) isolated were eradicated following its administration. Microbes which appeared after its dosing belonged to 9 classes of 18 strains, of which 5 strains (27.8%) of Serratia were identified. Side effects were 2.5% (3/119), no serious cases appeared. Changes in laboratory examination results were elevated GOT (2.5%), GPT (1.7%), and ALP (0.8%) values, all being transient hanges.

Adult↗
PubMed1985

High-performance liquid chromatography analysis of mezlocillin, piperacillin, their degradation products, and of ioxitalamic acid in plasma and urine of healthy volunteers.

In plasma and urine of 10 healthy volunteers after intravenous administration of 4 g mezlocillin and piperacillin, respectively, the parent compounds as well as degradation products were assayed by high-performance liquid chromatography. Ioxitalamic acid, a renal contrast medium, was administered simultaneously, in order to measure the glomerular filtration rate, and to control the collection of 24-h urine. As metabolite of mezlocillin the corresponding penicilloic acid only was found, whereas in the case of piperacillin a further degradation product was observed. Half of the doses given was recovered in the urine as unchanged drugs, and in addition 5-10% as metabolites. No differences were found in the pharmacokinetic behaviour of both antibiotics.

Adult↗
PubMedDate not supplied

[Comparative study of the in vitro activity of dibekacin, piperacillin, cefotaxime and cefuroxime on gram-negative bacteria].

The activity in vitro of the dibekacin was compared with that of piperacillin, cefotaxime and cefuroxime against 266 recently isolated gramnegative pathogens. Dibekacin was consistently more potent than cefotaxime, cefuroxime and piperacillin, with MIC50 and MIC90 values lower than the others. Dibekacin and cefotaxime were essentially similar in activity against all the bacteria, with the singular exception of Pseudomonas aeruginosa, which was markedly more susceptible to the former drug.

Anti-Bacterial Agents↗
PubMed1981

[Piperacillin: pharmacokinetic studies on the biliary and renal excretion (author's transl)].

9 patients (6 female, 3 male) with either cholelithiasis or choledocholithiasis submitted to cholecystectomy were studied during the postoperative period. Sodium 6-[D-(--)-alpha-(4-ethyl-2,3-dioxo-1-piperazinylcarbonylamino)-alpha-phenyl-ace tamido]penicillinate (piperacillin) was administered in single i.v. doses of 2 and 4 g on the 4th and 6th postoperative days. Serum samples were taken at intervals of 20 min over a period of 3 h post injection and bile was collected via T-tube drainage in 20-min periods also for 180 min. The total urine outputs were collected for the periods 0--6 h, 6--12 h and 12--24 h after administration of the drug. The maximum concentration of piperacillin in the bile was observed 60--120 min post administration. The values in the bile were found to exceed the corresponding serum concentrations 30--40fold. Within 3 h 9.6 (+/- 6.5)% and 13.4 (+/- 5.0)% were eliminated in the bile after 2 and 4 g injections, respectively. The percentage of the administered drug excreted in the urine within 24 h was 56.3% (2 g i.v.) and 66.0% (4 g i.v.).

Bile↗
PubMed1981

[Chemotherapy of biliary tract infections. XIV. Biliary excretion and gallbladder tissue levels of piperacillin (author's transl)].

Piperacillin, a new injectable synthetic penicillin, was evaluated against biliary tract infections. 1. Two grams of piperacillin was intravenously administered to patients received cholecystectomy. The mean level in gallbladder bile of PIPC was 795.6 microgram/ml except for 3 cases in obstruction of the cystic duct. The mean gallbladder tissue level was 31.2 microgram/g. The gallbladder tissue level in the cases with obstruction of the cystic duct was high levels as 71.3 microgram/g and 79.5 microgram/g. 2. The excretion of PIPC into bile was compared with TIPC and APPC using crossover method. When administered 2 g of PIPC, the peak biliary levels were 950 microgram/ml to 2,120 microgram/ml at 2 hours and 20 minutes to 2 hours and 40 minutes after the administration, and biliary recoveries during 6 hours were 2.84% to 11.6%. The peak levels and biliary recoveries were lower after administration of TIPC 2 g. Mn and Zn were excreted enormously together with APPC into human bile. 3. The influence on clinical laboratory findings was negligible. Therefore, PIPC may be expected to show excellent effects of biliary tract infections except rare occurrence of drug eruption.

Adult↗