Efficacy of tazobactam/piperacillin on complicated urinary tract infection and male accessory sex organ infection

Difficulties may occur in the treatment of complicated urinary tract infection (UTI) and male accessory sex organ infection partly because of the spread of antibiotic-resistant strains. The purpose of this study was to investigate the efficacy of tazobactam/piperacillin (TAZ/PIPC) on complicated UTI or male accessory sex organ infection. We examined 49 patients with complicated UTI or male accessory sex organ infection and their backgrounds, underlying diseases, doses of TAZ/PIPC, causative bacteria, treatment outcomes, involvement of bacteremia, and adverse events associated with TAZ/PIPC. The patients comprised 37 males and 12 females with ages ranging from 22-89 yr (median: 68 yr). The diagnoses of the infectious disease were as follows: 34 cases of complicated pyelitis, 11 acute prostatitis, 2 acute epididymitis and 2 others. There were 5 cases where bacteremia was involved. The underlying diseases were as follows: 11 cases of bladder cancer, 10 benign prostate hyperplasia, 8 ureteral stone, 6 renal pelvic or ureteral cancer, and there were 6 cases of diabetes mellitus. The daily doses of TAZ/PIPC were as follows: 4.5 g in 7 cases, 6.75 g in 3 cases, 9 g in 25 cases, 13.5 g in 12 cases and 18 g in 1 case. The urine culture was positive in 26 cases with 10 cases of Escherichia coli and 10 of Enterococcus faecalis; one case of extended-spectrum beta-lactamase (ESBL) producing bacteria was noted in the E. coli group. As for the treatment outcome, TAZ/PIPC was effective in 45 out of 49 cases (91.8%) and in detail, it was 30 out of 34 cases of complicated pyelitis (88.2%) and it was 11 out of 11 cases of acute prostatitis (100%). The TAZ/PIPC regimen did not have to be stopped in any of the patients as a result of the drug-induced adverse events. In summary, TAZ/PIPC is considered an effective and safe drug for the treatments of complicated UTI or male accessory sex organ infection.