Front Pharmacol. 2026 Aug 3;17:1757937. doi: 10.3389/fphar.2026.1757937. eCollection 2026.
ABSTRACT
OBJECTIVE: To compare the clinical outcomes associated with piperacillin-tazobactam (PIP-TAZ) versus cefotaxime-tazobactam (CTX-TAZ) in elderly patients with lower respiratory tract infection (LRTI).
METHODS: A total of 92 elderly patients with respiratory tract infection from March 2024 to April 2025 were selected as the subjects and divided into two groups of 46 cases in each group according to different treatment drugs. The control group was treated with tazobactam sodium/cefotaxime sodium, and the observation group was treated with piperacillin sodium for injection. The effects of the two groups were evaluated after 2 weeks of treatment. The blood gas level, inflammatory factors, lung function and drug safety were compared between the two groups.
RESULTS: Both groups showed significant improvements in arterial blood gases after treatment. Patients receiving PIP-TAZ exhibited a significantly greater increase in PaO2 and a greater reduction in PaCO2 compared to those receiving CTX-TAZ (both P < 0.05). Inflammatory markers (PCT, WBC, CRP) decreased, and pulmonary function indices (PEF, FVC, FEV1) increased significantly in both groups, with numerically greater improvements in the PIP-TAZ group (all P < 0.05, unadjusted). There was no statistical difference in drug safety between the two groups (P > 0.05).
CONCLUSION: In this comparative study, both piperacillin-tazobactam and cefotaxime-tazobactam demonstrated clinical effectiveness in improving objective physiological and inflammatory parameters in elderly patients with LRTIs. In this non-randomized comparison, the piperacillin-tazobactam regimen was associated with statistically significant, but unadjusted, differences favoring greater improvements in arterial blood gases (PaO2 and PaCO2), reductions in inflammatory biomarkers (PCT, WBC, CRP), and enhancements in lung function indices (PEF, FVC, FEV1) after 2 weeks of treatment compared to the cefotaxime-tazobactam regimen. These observed differences should be considered exploratory. Both treatments exhibited a comparable and acceptable safety profile in this cohort. However, these findings should be interpreted in light of the study’s non-randomized design, heterogeneous infection types, and the inherent differences between the antibiotic regimens. Further large-scale, randomized controlled trials with microbiological confirmation are warranted to validate these observations and define the optimal empiric antibiotic strategy in this vulnerable population.
PMID:42609393 | PMC:PMC13477961 | DOI:10.3389/fphar.2026.1757937
