Efficacy of piperacillin sodium and tazobactam sodium combined with acetylcysteine in treating elderly patients with severe pneumonia
WANG Yanbin
YU Wei
HU Kai
Abstract：Objective To explore the clinical efficacy and safety of piperacillin sodium and tazobactam sodium combined with acetylcysteine in the treatment of elderly patients with severe pneumonia.Methods A total of 86 elderly pa-tients with severe pneumonia admitted to the First People's Hospital of Zhumadian from June 2022 to December 2024 were selected and divided into two groups using the random number table method.The control group(43 cases)received conventional symptomatic treatment plus acetylcysteine therapy,while the observation group(43 cases)received conventional symptomatic treatment plus acetylcysteine plus piperacillin sodium and tazobactam sodium therapy.The clinical efficacy,respiratory dy-namics parameters(airway resistance(Raw),peak inspiratory pressure(PIP),mean airway pressure(MPaw),plateau pressure(Pplat)),blood gas analysis indicators(arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2),oxygenation index),serum stress indicators(adrenocorticotropic hormone(ACTH),cortisol(COR)),and the incidence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 93.02%(40/43),significantly higher than that of the control group(74.42%(32/43))(χ2=5.460,P<0.05).After treatment,the levels of Raw,MPaw and Pplat in both groups decreased compared with those before treatment,while the PIP level increased compared with that before treatment.The levels of Raw,MPaw and Pplat in the observation group were((6.18±1.21)cmH2O(1 cmH2O=0.098 kPa),(8.45±0.64)cmH2O,and(13.71±1.02)cmH2O,respectively)were lower than those in the control group((9.89±1.34)cmH2O,(9.67±0.91)cmH2O,and(16.16±1.11)cmH2O,respectively)(t=13.475,7.191,10.657,all P<0.05).The PIP level in the observation group((39.31±5.10)cmH2O)was higher than that in the control group((30.40±3.12)cmH2O)(t=9.773,P<0.05).After treatment,the PaCO2 levels in both groups decreased,while the PaO2 and oxygenation index levels in-creased.Moreover,the PaCO2 level in the observation group((39.65±4.42)mmHg(1 mmHg=0.133 kPa))was lower than that in the control group((47.48±5.61)mmHg)(t=7.189,P<0.05).The levels of PaO2 and oxygenation index((83.16±6.22)mmHg and(302.68±34.12)mmHg,respectively)in the observation group were higher than those in the control group((75.27±6.33)mmHg and(269.41±35.09)mmHg,respectively)(t=5.830,4.457,both P<0.05).After treatment,the levels of ACTH and COR in both groups decreased,and the levels in the observation group((196.88±22.01)pmol/L and(8.03±1.15)nmol/L,respective-ly)were lower than those in the control group((285.49±34.82)pmol/L and(9.57±1.11)nmol/L,respectively)(t=14.106,6.318,both P<0.05).The incidence of adverse reactions was 13.95%(6/43)in the observation group and 27.91%(12/43)in the control group,and there was no statistically significant difference between the two groups(χ2=2.529,P>0.05).Conclusion The combi-nation of piperacillin sodium and tazobactam sodium with acetylcysteine demonstrates good efficacy in treating elderly patients with severe pneumonia,which can effectively control pulmonary infection,regulate blood gas analysis and stress hormone indi-cators levels,reduce Raw,protect respiratory function,and exhibit favorable safety.
Keywords：piperacillin sodium and tazobactam sodiumacetylcysteinesevere pneumoniaclinical efficacy
Publication Date：2025-11-25
Online Publishing Date：2025-12-04(First online date of this platform, not the publication date of the document)
Pages：5( 1345-1349 )