Selection of piperacillin/tazobactam infusion mode guided by SOFA score in cancer patients with hospital-acquired pneumonia: a randomized controlled study

Background: This study aimed to select piperacillin/tazobactam (TZP) infusion mode guided by Sequential Organ Failure Assessment (SOFA) score in cancer patients with hospital-acquired pneumonia (HAP) postoperation. Patients and methods: A total of 120 cancer patients with postoperative HAP were divided into two groups: improved administration group (L group) and conventional treatment group (Con group). The Con group received traditional infusion of TZP and the L group received it as prolonged infusion. Blood drug concentration was detected at different time points. Based on the SOFA cut-off value of 9, the patients were regrouped into M (mild) and S (severe) groups. Results: Percent time that the free drug concentrations remain above the minimum inhibitory concentration (% fT > MIC) was longer than 5 h in L group, but < 4 h in Con group. Administration method (p=0.033, OX value 2.796, B value 1.028, 95% CI: 0.855-8.934) and SOFA score (p=0.038, OX value 0.080, B value -2.522, 95% CI: 0.007-0.874) were independent predictors of patient survival. In the S group, compared to conventional treatment, prolonged infusion mode resulted in shorter days of antibiotic use and shorter ventilator time, and achieved longer survival, better clinical efficacy, and lower 28-day mortality rate. Conclusion: For cancer patients with SOFA score >= 9, prolonged infusion of TZP could benefit the patients and obtain better clinical efficacy.C