Clinical Efficacy of Cefoperazone-Sulbactam versus Piperacillin-Tazobactam in the Treatment of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia

Chia-Hung Chen; Chih-Yen Tu; Wei-Chih Chen; Li-Kuo Kuo; Yao-Tung Wang; Pin-Kuei Fu; Shih-Chi Ku; Wen-Feng Fang; Chin-Ming Chen; Chih-Cheng Lai

doi:10.2147/IDR.S313828

Clinical Efficacy of Cefoperazone-Sulbactam versus Piperacillin-Tazobactam in the Treatment of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia

Infect Drug Resist. 2021 Jun 16:14:2251-2258. doi: 10.2147/IDR.S313828. eCollection 2021.

Authors

Chia-Hung Chen¹, Chih-Yen Tu¹, Wei-Chih Chen², Li-Kuo Kuo³, Yao-Tung Wang⁴, Pin-Kuei Fu⁵, Shih-Chi Ku⁶, Wen-Feng Fang⁷, Chin-Ming Chen⁸, Chih-Cheng Lai⁹

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
² Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
³ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
⁴ Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁵ Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
⁶ Division of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁷ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁸ Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.
⁹ Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

Abstract

Objective: The aim of this study was to compare the usefulness of cefoperazone-sulbactam and that of piperacillin-tazobactam in the treatment of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP).

Methods: This retrospective study included the adult patients receiving cefoperazone-sulbactam or piperacillin-tazobactam against HAP/VAP in nine hospitals in Taiwan from March 1, 2018 to May 30, 2019. Primary outcome was clinical cure rate.

Results: A total of 410 patients were enrolled. Among them, 209 patients received cefoperazone-sulbactam and 201 patients received piperacillin-tazobactam. Overall, cefoperazone-sulbactam group had similar distribution of age, sex, or SOFA scores as piperacillin-tazobactam group. However, cefoperazone-sulbactam had higher comorbidity score and disease severity than piperacillin-tazobactam group (Charlson score: 6.5 ± 2.9 vs 5.7 ± 2.7, p < 0.001; APACHE II score: 21.4 ± 6.2 vs 19.3 ± 6.0, p = 0.002). Regarding clinical outcomes, no significant difference in clinical cure and failure rates was observed between cefoperazone-sulbactam and piperacillin-tazobactam group (clinical cure rate: 80.9% vs 80.1% and clinical failure rate: 17.2% vs 18.4%, p = 0.943). Moreover, no significant difference in clinical effectiveness and ineffectiveness rates was observed between cefoperazone-sulbactam and piperacillin-tazobactam group (clinical effective rate: 80.9% vs 80.6% and clinical ineffective rate: 17.7% vs 18.9%, p = 0.711). The all-cause mortality rates of the cefoperazone-sulbactam and piperacillin-tazobactam groups were similar (23.9% vs 20.9%, p = 0.48). After adjustment of Charlson score and APACHE II score, the similarities in these clinical outcomes did not change in overall patients and patients with HAP or VAP.

Conclusion: For treating adult patients with nosocomial pneumonia, cefoperazone-sulbactam was as effective as piperacillin-tazobactam.

Keywords: cefoperazone-sulbactam; hospital-acquired pneumonia; piperacillin-tazobactam; ventilator-associated pneumonia.

Grants and funding

No funding was received.