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piperacillin (piperacillin, KRKA / Isipen)

✓ Approved

Krka · 小分子 · 小分子

什么是 piperacillin？

piperacillin 是一种小分子，由Krka研发。该药已获批，用于治疗相关适应症，给药途径：Unknown。

药物档案

商品名piperacillin, KRKA, Isipen
公司Krka
药物类别小分子
给药途径Unknown
状态Approved
来源： ClinicalTrials.gov, Krka

治疗适应症

piperacillin 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Infections and infestationsSalmonellosis✓ Approved

相关研究文献

PubMedAntibiotics (Basel, Switzerland)2026-07-27

Evaluation of Short Versus Long Course of Tobramycin Combined with Piperacillin/Tazobactam Against Antibiotic-Resistant Pseudomonas aeruginosa in a Hollow Fibre Infection Model.

Wale Yalew M YM, Roberts Jason A JA, Won Hayoung H, Reghu Sheethal S et al.

Aminoglycosides are commonly partnered with β-lactam antibiotics for empirical treatment of severe Gram-negative bacterial infections, including those caused by Pseudomonas aeruginosa. However, the optimal duration of aminoglycoside therapy when co-administered with β-lactam antibiotics remains poorly defined. This study compared the antibacterial efficacy of short (one-day, three-day) versus long course (seven-day) of tobramycin therapy, co-administered with piperacillin/tazobactam, against piperacillin/tazobactam-resistant clinical isolates of P. aeruginosa in a hollow fibre infection model (HFIM). A broth microdilution method was used to determine the minimum inhibitory concentration (MIC) of the antibiotics. The HFIM experiments were performed using two piperacillin/tazobactam-resistant clinical isolates, CTAP-32 and CTAP-72 (both with piperacillin/tazobactam MICs > 128 mg/L). The clinical dose of tobramycin (10 mg/kg/day IV) was simulated for one, three, and seven days, each in combination with piperacillin/tazobactam (4.5 g every six hours infused over 30 min). In the HFIM, the one-day, three-day, and seven-day courses of tobramycin administered with piperacillin/tazobactam resulted in comparable bacterial kill with ~3log10 CFU/mL bacterial density reduction within the first 8 h of treatment against the CTAP-32 bacterial isolate. Similarly, these three combination regimens resulted in equivalent bacterial killing effects against the CTAP-72 isolate with a ~5log10 CFU/mL bacterial reduction during the initial treatment period. However, despite this early decline, comparable bacterial regrowth was observed thereafter with the short versus the long course of tobramycin co-administered with piperacillin/tazobactam. In conclusion, short-course and long-course tobramycin therapy, when combined with piperacillin/tazobactam, achieved comparable antibacterial efficacy against P. aeruginosa isolates in the HFIM. However, these findings warrant further validation in clinical studies.

PMID 42505648
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PubMedAntibiotics (Basel, Switzerland)2026-07-27

Changes in Antibiotic Resistance Patterns in Diabetic Foot Infections Requiring Toe Amputation: A Long-Term Single-Center Retrospective Study.

Özgözen Alaaddin Levent AL, Altunay Enes E

Objectives: Diabetic foot infections are a major cause of morbidity and amputation, and increasing antibiotic resistance complicates their management. This study aimed to evaluate longitudinal changes in antibiotic resistance among bacterial pathogens isolated from patients undergoing toe amputation due to diabetic foot infections. Methods: This retrospective, single-center study included patients who underwent toe amputation for diabetic foot infections between 2013 and 2024. Microbiological culture results and antimicrobial susceptibility data were analyzed across three consecutive time periods: 2013-2016, 2017-2020, and 2021-2024. Results: A total of 351 patients were included (mean age, 64.1 years; 64% male). A history of dialysis was present in 30% of patients, and 54% had a history of prior hospitalization. A total of 351 patients were included in the study. A total of 378 bacterial isolates recovered from positive microbiological cultures were included in the antimicrobial susceptibility analysis. The most frequently isolated microorganisms were Escherichia coli, Enterococcus spp., coagulase-negative Staphylococcus, and Staphylococcus aureus. Among Enterobacterales isolates, statistically significant increases in resistance across the three consecutive time periods were observed for amoxicillin-clavulanate (p = 0.009), piperacillin-tazobactam (p = 0.002), trimethoprim-sulfamethoxazole (p = 0.012), and meropenem (p = 0.027), whereas the increase in imipenem resistance did not reach statistical significance (p = 0.054). Within Staphylococcus spp., a statistically significant increase in resistance across the three consecutive time periods was observed only for ciprofloxacin (p = 0.047). Conclusions: Changes in antimicrobial resistance rates were observed among bacterial isolates recovered from diabetic foot infections across the three consecutive time periods, highlighting the importance of regional surveillance and up-to-date local resistance data for guiding empirical antibiotic therapy.

PMID 42505644
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PubMedInfection and drug resistance2026-07-27

Risk Stratification for Vancomycin-Associated Acute Kidney Injury in Chinese Adult Inpatients: A Multicenter Retrospective Cohort Study.

Chen Shu S, Zhang Ying Y, Hou Xingyun X, Wang Yuzhu Y et al.

Vancomycin-associated acute kidney injury (VA-AKI) remains a major safety concern during treatment of serious infections. We aimed to identify a clinically relevant vancomycin trough threshold associated with VA-AKI and to define factors associated with renal injury in Chinese adult inpatients. We conducted a multicenter retrospective cohort study of 2230 Chinese adult inpatients treated with intravenous vancomycin between 2016 and 2025. VA-AKI was defined according to Kidney Disease: Improving Global Outcomes criteria. Receiver operating characteristic analysis was used to identify the trough threshold associated with VA-AKI, and multivariable logistic regression was performed to assess factors independently associated with VA-AKI. VA-AKI occurred in 493/2230 patients (22.1%). The trough concentration most closely associated with VA-AKI was 15.9 mg/L (AUC 0.64). Compared with troughs <10 mg/L, concentrations of 10-20 mg/L and >20 mg/L were associated with progressively higher AKI risk. Factors independently associated with VA-AKI included contrast exposure, concomitant piperacillin-tazobactam or cephalosporin therapy, critical illness, treatment duration ≥14 days, cardiac dysfunction, and baseline renal impairment. VA-AKI was also associated with worse outcomes, including higher 60-day mortality (16% vs 4%) and greater dialysis requirement (6% vs 2%). In this large multicenter cohort, VA-AKI occurred in approximately one in five Chinese adult inpatients receiving vancomycin. A vancomycin trough concentration of approximately 15.9 mg/L may serve as a practical threshold for early AKI risk stratification, particularly in clinical settings where AUC-guided monitoring is not routinely available. Closer renal surveillance may be warranted in patients with additional treatment-related or clinical risk factors.

PMID 42504291
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PubMedHCA healthcare journal of medicine2026-07-25

Autoimmune Hemolytic Anemia Associated With Leptospirosis: A Rare Complication.

Waqar Anum A, Mazhar Furqan F, Afzal Mahrukh M, Razzaq Sadia S et al.

Autoimmune hemolytic anemia (AIHA) is rare but potentially life-threatening complication of leptospirosis, a zoonotic infection caused by the Leptospira species. Autoimmune hemolytic anemia occurs when the immune system targets red blood cells, resulting in hemolysis and anemia. The relationship between leptospirosis and AIHA is uncommon and often under-recognized, which can delay diagnosis and management. This case highlights the importance of considering hematologic complications in leptospirosis. A 23-year-old male presented with low-grade fever, productive cough, shortness of breath, jaundice, and pallor for 15 days. On examination, he was pale and icteric with bilateral chest crepitations. Laboratory studies showed severe anemia (hemoglobin 5.5 g/dL), elevated lactate dehydrogenase (1027 U/L), hyperbilirubinemia, thrombocytopenia, and peripheral smear evidence of hemolysis. A direct Coombs' test was strongly positive. Leptospira immunoglobulin M serology confirmed the diagnosis. The patient was managed with broad-spectrum antibiotics (piperacillin-tazobactam and doxycycline) and high-dose corticosteroids (1 mg/kg/day). He improved clinically with stabilization of hemoglobin and a resolution of symptoms. This case demonstrates a rare immune-mediated manifestation of leptospirosis presenting as AIHA without hepatic or renal failure. Clinicians should maintain a high index of suspicion for hematologic complications in leptospirosis. Early recognition and timely initiation of corticosteroid therapy alongside antibiotics can improve patient outcomes.

PMID 42500446
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PubMedInternational ophthalmology2026-07-25

Antimicrobial resistance in post-cataract endophthalmitis: a systematic review on resistance pattern and treatment outcomes.

Yan Martin Chi Kit MCK, Rees Amelia A, Saleki Mohammad M

To systematically review the microbiological spectrum, antimicrobial resistance (AMR) patterns, management strategies, and outcomes in culture-positive endophthalmitis, a rare vision-threatening complication of cataract surgery increasingly challenged by resistance. A comprehensive literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from 1 January 1990 to 30 June 2025. Eligible studies included culture-positive cases of acute Post-Cataract Endophthalmitis reporting antimicrobial susceptibility and outcomes. Data were extracted on organisms, resistance profiles, treatment strategies and visual acuity. Risk of bias was assessed using the ROBINS-I tool. Six studies (five retrospective, one prospective) from Europe, Asia, and North America met inclusion criteria. Coagulase-negative staphylococci predominated, with frequent methicillin and fluoroquinolone resistance; Staphylococcus, Streptococcus, and Pseudomonas were less common. An Indian cohort described multidrug-resistant Pseudomonas with near-universal resistance to fluoroquinolones, aminoglycosides, and cephalosporins but susceptibility to colistin, piperacillin, and imipenem. While vancomycin remained active against Gram-positive organisms, emerging resistance was reported in the United Kingdom. Visual outcomes varied: tap-and-inject was comparable to early pars plana vitrectomy (PPV), except in Gram-negative infections where PPV conferred benefit. Amikacin resistance correlated with poorer outcomes, whereas vancomycin or moxifloxacin resistance did not. Systemic antibiotics and intravitreal corticosteroids showed no consistent benefit. AMR in Post-Cataract Endophthalmitis is an escalating concern with marked geographic variation. Prompt intravitreal therapy remains the key determinant of prognosis, but empiric regimens must reflect local resistance trends, particularly for Gram-negative coverage. Current evidence is limited by retrospective design and regional variability; multicentre prospective studies are needed to refine prophylaxis and treatment protocols, reducing visual and economic burden.

PMID 42498831
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PubMedInfection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases2026-07-25

Global genomic surveillance of β-lactam resistance in Escherichia coli across human, animal, and environmental reservoirs.

Sholeh Mohammad M, Beig Masoumeh M, Kiani Negin N, Badmasti Farzad F

Escherichia coli poses a global health threat from increasing β-lactam resistance. This study uses genomic and One-Health data to map resistance patterns and enhance antimicrobial resistance (AMR) prediction and management. This study performed a One-Health whole-genome analysis of 30,554 E. coli isolates from human, animal, and environmental sources, spanning from 2000 to 2025. Publicly available genomic data were retrieved from NCBI, encompassing β-lactam resistance genes, including extended-spectrum β-lactamases, AmpC, and carbapenemases, along with key chromosomal resistance modifiers. These genes were identified and curated using AMRFinderPlus. Multilocus sequence typing (MLST) and pathotype assignments were conducted in silico. Temporal, host, sequence-type (ST), and geographic patterns of resistance were modeled, with gradient-boosted machine learning algorithms predicting minimum inhibitory concentrations (MICs) based on antibiotic resistance gene profiles and chromosomal features. Temporal and geographic resistance patterns were further analyzed using statistical and visualization tools in R and Python. A total of 30,554 E. coli whole-genome sequences from isolates spanning 126 countries between 2000 and 2025 were analyzed. The dataset included 2015 complete genomes, 177 chromosome-level assemblies, 8310 scaffold-level assemblies, and 20,052 contig-level assemblies, with an average sequence length of 5,120,983 bp. Isolates were categorized by host source: 14,320 from humans, 8184 from animals, 3941 from environmental sources, and 4109 with an unknown source. MLST was successfully performed on 29,648 isolates, identifying dominant STs such as ST131, ST11, and ST10. Human isolates were predominantly associated with epidemic clones ST131, ST73, and ST1193, while animal isolates were associated with ST10, and environmental isolates showed a strong presence of ST155. Temporal analyses indicated a steady increase in β-lactam resistance, with blaCTX-M-15, blaNDM-5, and blaOXA-1 showing the most significant prevalence trends. Model performance was strongest for carbapenems, particularly imipenem (R2 = 0.88) and ertapenem (R2 = 0.74), whereas predictions for ampicillin and piperacillin-tazobactam showed poor agreement with observed MICs. Global analysis of 30,554 genomes shows rising β-lactam resistance driven by key genes (blaCTX-M-15, blaNDM-5, blaOXA-1) in high-risk clones. Machine learning accurately predicted carbapenem resistance but struggled with β-lactamase inhibitor combos. Integrating genomics and One-Health data can guide AMR surveillance and control.

PMID 42498094
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