RT Journal Article
T1 Ertapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: a multinational pre-registered cohort study.
A1 Gutierrez-Gutierrez, Belen
A1 Bonomo, Robert A
A1 Carmeli, Yehuda
A1 Paterson, David L
A1 Almirante, Benito
A1 Martinez-Martinez, Luis
A1 Oliver, Antonio
A1 Calbo, Esther
A1 Peña, Carmen
A1 Akova, Murat
A1 Pitout, Johann
A1 Origüen, Julia
A1 Pintado, Vicente
A1 Garcia-Vazquez, Elisa
A1 Gasch, Oriol
A1 Hamprecht, Axel
A1 Prim, Nuria
A1 Tumbarello, Mario
A1 Bou, German
A1 Viale, Pierluigi
A1 Tacconelli, Evelina
A1 Almela, Manel
A1 Perez, Federico
A1 Giamarellou, Helen
A1 Cisneros, Jose Miguel
A1 Schwaber, Mitchell J
A1 Venditti, Mario
A1 Lowman, Warren
A1 Bermejo, Joaquin
A1 Hsueh, Po-Ren
A1 Mora-Rillo, Marta
A1 Gracia-Ahulfinger, Irene
A1 Pascual, Alvaro
A1 Rodriguez-Baño, Jesus
K1 Anti-bacterial agents
K1 Carbapenems
K1 Enterobacteriaceae
K1 Enterobacteriaceae infections
AB Data about the efficacy of ertapenem for the treatment of bloodstream infections (BSI) due to ESBL-producing Enterobacteriaceae (ESBL-E) are limited. We compared the clinical efficacy of ertapenem and other carbapenems in monomicrobial BSI due to ESBL-E. A multinational retrospective cohort study (INCREMENT project) was performed (ClinicalTrials.gov identifier: NCT01764490). Patients given monotherapy with ertapenem or other carbapenems were compared. Empirical and targeted therapies were analysed. Propensity scores were used to control for confounding; sensitivity analyses were performed in subgroups. The outcome variables were cure/improvement rate at day 14 and all-cause 30 day mortality. The empirical therapy cohort (ETC) and the targeted therapy cohort (TTC) included 195 and 509 patients, respectively. Cure/improvement rates were 90.6% with ertapenem and 75.5% with other carbapenems (P = 0.06) in the ETC and 89.8% and 82.6% (P = 0.02) in the TTC, respectively; 30 day mortality rates were 3.1% and 23.3% (P = 0.01) in the ETC and 9.3% and 17.1% (P = 0.01) in the TTC, respectively. Adjusted ORs (95% CI) for cure/improvement with empirical and targeted ertapenem were 1.87 (0.24-20.08; P = 0.58) and 1.04 (0.44-2.50; P = 0.92), respectively. For the propensity-matched cohorts it was 1.18 (0.43-3.29; P = 0.74). Regarding 30 day mortality, the adjusted HR (95% CI) for targeted ertapenem was 0.93 (0.43-2.03; P = 0.86) and for the propensity-matched cohorts it was 1.05 (0.46-2.44; P = 0.90). Sensitivity analyses were consistent except for patients with severe sepsis/septic shock, which showed a non-significant trend favouring other carbapenems. Ertapenem appears as effective as other carbapenems for empirical and targeted therapy of BSI due to ESBL-E, but further studies are needed for patients with severe sepsis/septic shock.
PB Oxford University Press
YR 2015
FD 2015-12-26
LK http://hdl.handle.net/10668/9859
UL http://hdl.handle.net/10668/9859
LA en
NO Gutiérrez-Gutiérrez B, Bonomo RA, Carmeli Y, Paterson DL, Almirante B, Martínez-Martínez L, et al. Ertapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: a multinational pre-registered cohort study. J Antimicrob Chemother. 2016 Jun;71(6):1672-80
DS RISalud
RD Apr 5, 2025