piperacillin--tazobactam-drug-combination and Pulmonary-Disease--Chronic-Obstructive

Chronic obstructive pulmonary disease (COPD) is a common, chronic inflammatory disease of the airway, and acute exacerbation of COPD (AE-COPD) refers to the manifestations of inflammation in the lungs that appear within a short period of time. Some patients contract pneumonia, and they can be prone to recurrent attacks of AE-COPD combined with pneumonia. The efficacy of conventional treatments isn't generally satisfactory.. The study intended to investigate the effectiveness and safety of piperacillin tazobactam in combination with the use of high-frequency chest-wall oscillation (HFCWO) to produce expectoration for the treatment of pneumonia in patients with AE-COPD and to provide a reference for clinical treatment.. The research team designed a prospective, randomized controlled trial.. The study took place at the Sixth Hospital of Wuhan of the Affiliated Hospital of Jianghan University in Wuhan, China.. Participants were 92 patients who had been admitted to the hospital between January 2020 and November 2021 with AE-COPD combined with pneumonia.. Using the random number table method, the research team randomly assigned participants to one of two groups, an intervention group or a control group, each with 46 participants. The control group received conventional treatment with oxygen, antibiotics, antispasmodics, antiasthmatic drugs, and phlegmolytic drugs as well as HFCWO for sputum removal. In addition to those treatments, the intervention group received piperacillin tazobactam.. The research team measured the treatment's efficacy at one day postintervention. At baseline and at one day postintervention, the study also measured pulmonary function, laboratory indexes, and blood-gas-analysis indexes. In addition, the research team identified the time of disappearance of clinical symptoms, including the disappearance of cough, sputum, dyspnea, and pulmonary rales; calculated the length of hospital stay, and evaluated the treatment's safety.. Postintervention, the intervention group's clinical efficacy was significantly higher than that of the control group (P < .05), and the group's cough, coughing of sputum, dyspnea, disappearance time of pulmonary rales, and hospitalization times were all significantly lower than those in the control group (P < .05). The FEV1, FVC, FEV1% and FEV1/FVC levels were higher in both groups postintervention than at baseline and were significantly higher in the intervention group than in the control group (P < .05). Postintervention, the levels of IL-2, IL-10, TNF-α, CRP and PCT were lower in both groups than at baseline, and the intervention group's levels were significantly lower than those in the control group (P < .05). Postintervention, the PaCO2 level decreased and PaO2 and SaO2 levels increased in both groups compared to baseline; the intervention group's PaCO2 level was lower and PaO2 and SaO2 levels were higher than those in the control group. During the treatment, no adverse reactions occurred in the control group, and one participant had a decreased appetite in the intervention group; the incidence of adverse reactions in that group was 2.17% (1/46). That participant received no special treatment, and the condition improved after stopping the drug.. Piperacillin tazobactam combined with HFCWO for sputum evacuation can effectively treat patients with pneumonia in acute exacerbation of COPD, with high safety. The treatment is worthy of clinical application.

Topics: Chest Wall Oscillation; Cough; Dyspnea; Humans; Oxygen; Piperacillin, Tazobactam Drug Combination; Pneumonia; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Respiratory Sounds

The goal of this paper was to investigate the predictive value on the efficacy of C-reactive protein (CRP), procalcitonin (PCT), and erythrocyte sedimentation rate (ESR) on piperacillin-tazobactam in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pneumonia.. From January 2018 to May 2021, 52 AECOPD patients (AECOPD group) and 91 AECOPD patients with pneumonia (pneumonia group) were enrolled, and the levels of CRP, PCT, and ESR were compared. The pneumonia group was divided into a mild group and a severe group, and the correlation between the levels of CRP, PCT, and ESR and the severity of pneumonia was analyzed. The patients in the pneumonia group were treated with piperacillin and tazobactam, and the clinical efficacy of CRP, PCT, and ESR levels was analyzed.. The pneumonia group, particularly the severe subtype, had higher CRP, PCT, and ESR than the AECOPD group. CRP, PCT, and ESR levels were related to the severity of pneumonia and were negatively associated with the efficacy of piperacillin and tazobactam. The AUC of the combined detection of CRP, PCT, and ESR levels was greater than 0.8 to evaluate the efficacy of piperacillin-tazobactam treatment. CRP ≥ 67.19 mg/L, PCT ≥ 1.73 ng/mL, and ESR ≥ 29.42 mm/hour were the related factors affecting the efficacy of piperacillin-tazobactam.. CRP, PCT, and ESR levels are related to the severity of AECOPD complicated with pneumonia, and have value in evaluating the efficacy of piperacillin-tazobactam.

Topics: Biomarkers; Blood Sedimentation; C-Reactive Protein; Calcitonin; Humans; Piperacillin, Tazobactam Drug Combination; Pneumonia; Procalcitonin; Pulmonary Disease, Chronic Obstructive

Topics: Anti-Bacterial Agents; Antifungal Agents; Aspergillus niger; Carcinoma, Squamous Cell; Fungemia; Humans; Male; Middle Aged; Piperacillin, Tazobactam Drug Combination; Pulmonary Aspergillosis; Pulmonary Disease, Chronic Obstructive; Thyroid Neoplasms; Vancomycin; Voriconazole

A heart transplant 62-year-old patient referred for coronavirus-19 disease (COVID-19) pneumonia. At admission, he was febrile, tachypnoeic, and mild hypoxic with dry cough; during hospitalization, a diffuse morbilliform skin rash appeared. He was treated with tocilizumab with symptoms improvement, without a complete pulmonary function recovery. Skin rash, highly suggestive for COVID-19 cutaneous involvement, persisted for ten days despite tocilizumab administration.

Topics: Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Anticoagulants; Cardiomyopathy, Dilated; Cough; COVID-19; COVID-19 Drug Treatment; Diarrhea; Enoxaparin; Enzyme Inhibitors; Exanthema; Fever; Glucocorticoids; Heart Transplantation; Humans; Hydroxychloroquine; Hypoxia; Immunocompromised Host; Immunosuppressive Agents; Male; Methylprednisolone; Middle Aged; Nausea; Piperacillin, Tazobactam Drug Combination; Pulmonary Disease, Chronic Obstructive; Renal Insufficiency, Chronic; SARS-CoV-2; Tachypnea; Treatment Outcome

We report the case of a 52-year-old man, ASA 3-4, malnourished, heavy smoker and drinker at the stage of chronic obstructive pulmonary disease and cirrhosis. The postoperative course of a cervical cancer surgery was complicated by a pneumonia with fatal outcome in the intensive care unit. Taking into account the patient's history and surgical requirements, this nosocomial infection did not appear easily preventable. The multiple risk factors and the few preventive measures usable were analyzed. In this context, the media and legal trend to make the doctors responsible for the nosocomial infections should be revised.

Topics: Alcoholism; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Carcinoma, Squamous Cell; Ciprofloxacin; Cross Infection; Disease Susceptibility; Fatal Outcome; Humans; Iatrogenic Disease; Immunocompromised Host; Liver Cirrhosis, Alcoholic; Male; Malnutrition; Malpractice; Middle Aged; Mouth; Neck Dissection; Neoplasm Recurrence, Local; Oxygen; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pneumonia; Postoperative Complications; Pulmonary Disease, Chronic Obstructive; Risk Factors; Smoking; Tongue Neoplasms