Abstract
Piperacillin, a new semisynthetic penicillin, was evaluated for efficacy and safety in 26 patients, most of whom had pneumonia. Included were four patients with gram-negative meningitis in whom the penetration of piperacillin into cerebrospinal fluid was determined. Cure was achieved in 11 of 17 patients with pneumonia; another 4 were improved. One relapse and one failure occurred among nine patients with gram-negative pneumonia. Cure or improvement occurred in seven of nine patients with gram-negative infection in various extrapulmonary sites. Piperacillin given by continuous infusion in a dosage ranging from 324 to 436 mg/kg of body weight per day to four patients with meningitis resulted in a mean cerebrospinal fluid level of 23 micrograms/ml at 24 h; the mean penetration of piperacillin into the cerebrospinal fluid was 32% at this interval. Levels of piperacillin in cerebrospinal fluid collected later during the course of therapy were also adequate. Adverse effects were noted in six patients, but only one episode of granulocytopenia was serious. Emergence of resistance to piperacillin did not occur, and only one superinfection was noted. Piperacillin appeared to be efficacious in the treatment of pneumonia. It penetrated well into the cerebrospinal fluid of patients with meningitis and may be useful for treatment of selected gram-negative infections in extrapulmonary sites.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Batra V. K., Morrison J. A., Lasseter K. C., Joy V. A. Piperacillin kinetics. Clin Pharmacol Ther. 1979 Jul;26(1):41–53. doi: 10.1002/cpt197926141. [DOI] [PubMed] [Google Scholar]
- Bauer A. W., Kirby W. M., Sherris J. C., Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966 Apr;45(4):493–496. [PubMed] [Google Scholar]
- Beam T. R., Jr, Allen J. C. Blood, brain, and cerebrospinal fluid concentrations of several antibiotics in rabbits with intact and inflamed meninges. Antimicrob Agents Chemother. 1977 Dec;12(6):710–716. doi: 10.1128/aac.12.6.710. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bodey G. P., Le Blanc B. Piperacillin: in vitro evaluation. Antimicrob Agents Chemother. 1978 Jul;14(1):78–87. doi: 10.1128/aac.14.1.78. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Corbett C. L., Holdsworth C. D. Fever, abdominal pain, and leucopenia during treatment with cimetidine. Br Med J. 1978 Mar 25;1(6115):753–754. doi: 10.1136/bmj.1.6115.753-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Couchonnal G. J., Hinthorn D. R., Hodges G. R., Liu C. Nafcillin-associated granulocytopenia. South Med J. 1978 Nov;71(11):1356–1358. doi: 10.1097/00007611-197811000-00012. [DOI] [PubMed] [Google Scholar]
- Dacey R. G., Sande M. A. Effect of probenecid on cerebrospinal fluid concentrations of penicillin and cephalosporin derivatives. Antimicrob Agents Chemother. 1974 Oct;6(4):437–441. doi: 10.1128/aac.6.4.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dickinson G. M., Cleary T. J., Hoffman T. A. Comparative evaluation of piperacillin in vitro. Antimicrob Agents Chemother. 1978 Dec;14(6):919–921. doi: 10.1128/aac.14.6.919. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Forshaw J. Penicillin-induced granulopenia. Br Med J. 1968 Jul 20;3(5611):184–184. doi: 10.1136/bmj.3.5611.184. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fu K. P., Neu H. C. Piperacillin, a new penicillin active against many bacteria resistant to other penicillins. Antimicrob Agents Chemother. 1978 Mar;13(3):358–367. doi: 10.1128/aac.13.3.358. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hieber J. P., Nelson J. D. A pharmacologic evaluation of penicillin in children with purulent meningitis. N Engl J Med. 1977 Aug 25;297(8):410–413. doi: 10.1056/NEJM197708252970802. [DOI] [PubMed] [Google Scholar]
- KUNIN C. M., FINLAND M. Demethylchlortetracycline; a new tetracycline antibiotic that yields greater and more sustained antibacterial activity. N Engl J Med. 1958 Nov 20;259(21):999–1005. doi: 10.1056/NEJM195811202592102. [DOI] [PubMed] [Google Scholar]
- Marymont J. H., Jr, Wentz R. M. Serial dilution antibiotic sensitivity testing with the microtitrator system. Am J Clin Pathol. 1966 May;45(5):548–551. doi: 10.1093/ajcp/45.5.548. [DOI] [PubMed] [Google Scholar]
- Murray P. R., Washington J. A. Microscopic and baceriologic analysis of expectorated sputum. Mayo Clin Proc. 1975 Jun;50(6):339–344. [PubMed] [Google Scholar]
- Norrby R. A review of the penetration of antibiotics into CSF and its clinical significance. Scand J Infect Dis Suppl. 1978;(14):296–309. [PubMed] [Google Scholar]
- Reyes M. P., Palutke M., Lerner A. M. Granulocytopenia associated with carbenicillin. Five episodes in two patients. Am J Med. 1973 Mar;54(3):413–418. doi: 10.1016/0002-9343(73)90036-3. [DOI] [PubMed] [Google Scholar]
- Shishido H., Matsumoto K. Meningitis due to Haemophilus influenzae type e biotype 4. J Clin Microbiol. 1979 Dec;10(6):926–927. doi: 10.1128/jcm.10.6.926-927.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simon G. L., Snydman D. R., Tally F. P., Gorbach S. L. Clinical trial of piperacillin with acquisition of resistance by Pseudomonas and clinical relapse. Antimicrob Agents Chemother. 1980 Jul;18(1):167–170. doi: 10.1128/aac.18.1.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Strausbaugh L. J., Mandaleris C. D., Sande M. A. Cefamandole and ampicillin therapy in experimental Haemophilus influenzae meningitis. J Infect Dis. 1977 Feb;135(2):210–216. doi: 10.1093/infdis/135.2.210. [DOI] [PubMed] [Google Scholar]
- Ueo K., Fukuoka Y., Hayashi T., Yasuda T., Taki H., Tai M., Watanabe Y., Saikawa I., Mitsuhashi S. In vitro and in vivo antibacterial activity of T-1220, a new semisynthetic penicillin. Antimicrob Agents Chemother. 1977 Oct;12(4):455–460. doi: 10.1128/aac.12.4.455. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Verbist L. In vitro activity of piperacillin, a new semisynthetic penicillin with an unusually broad spectrum of activity. Antimicrob Agents Chemother. 1978 Mar;13(3):349–357. doi: 10.1128/aac.13.3.349. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Winston D. J., Murphy W., Young L. S., Hewitt W. L. Piperacillin therapy for serious bacterial infections. Am J Med. 1980 Aug;69(2):255–261. doi: 10.1016/0002-9343(80)90386-1. [DOI] [PubMed] [Google Scholar]
- Winston D. J., Wang D., Young L. S., Martin W. J., Hewitt W. L. In vitro studies of piperacilin, a new semisynthetic penicillin. Antimicrob Agents Chemother. 1978 Jun;13(6):944–950. doi: 10.1128/aac.13.6.944. [DOI] [PMC free article] [PubMed] [Google Scholar]