Real-world effectiveness of piperacillin/tazobactam with and without linezolid for spontaneous bacterial peritonitis
Digestive Diseases Feb 02, 2022
For spontaneous bacterial peritonitis (SBP) with low risk of multidrug-resistant organisms, empiric therapy with piperacillin/tazobactam (TZP) has been recommended in guidelines. Researchers herein examined the clinical benefit of coverage of beta-lactam-resistant Gram-positive bacteria, such as ampicillin-resistant Enterococcus faecium, in such situations.
Observational study involving the investigation of the real-world effectiveness of empirical therapy with TZP monotherapy vs TZP plus linezolid (LZD) combination therapy in SBP.
The first cohort had occurrences of 100 SBP episodes that were empirically treated with TZP+LZD combination therapy (n = 50) or PTZ monotherapy (n = 50); there were treatment failures (defined as the need to escalate antibiotic therapy due to in vitro resistance, lack of neutrophil decrease in ascitic fluid, or clinical decision, and 30-day survival) in 48% with TZP monotherapy vs 16% with TZP+LZD combination therapy.
The second cohort of 41 patients received empirical treatment with TZP; 37% had an occurrence of treatment failure, which was also higher than in episodes treated with TZP+LZD in cohort 1.
Overall, there were fewer treatment failures in correlation with providing empirical TZP+LZD combination therapy with no impact on short-term survival of patients with SBP.
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