RT Journal Article
T1 Empiric Therapy With Carbapenem-Sparing Regimens for Bloodstream Infections due to Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Results From the INCREMENT Cohort.
A1 Palacios-Baena, Zaira Raquel
A1 Gutierrez-Gutierrez, Belen
A1 Calbo, Esther
A1 Almirante, Benito
A1 Viale, Pierluigi
A1 Oliver, Antonio
A1 Pintado, Vicente
A1 Gasch, Oriol
A1 Martinez-Martinez, Luis
A1 Pitout, Johann
A1 Akova, Murat
A1 Peña, Carmen
A1 Molina Gil-Bermejo, Jose
A1 Hernandez, Alicia
A1 Venditti, Mario
A1 Prim, Nuria
A1 Bou, German
A1 Tacconelli, Evelina
A1 Tumbarello, Mario
A1 Hamprecht, Axel
A1 Giamarellou, Helen
A1 Almela, Manel
A1 Perez, Federico
A1 Schwaber, Mitchell J
A1 Bermejo, Joaquin
A1 Lowman, Warren
A1 Hsueh, Po-Ren
A1 Paño-Pardo, Jose Ramon
A1 Torre-Cisneros, Julian
A1 Souli, Maria
A1 Bonomo, Robert A
A1 Carmeli, Yehuda
A1 Paterson, David L
A1 Pascual, Alvaro
A1 Rodriguez-Baño, Jesus
K1 Aminoglycosides
K1 Antimicrobial resistance
K1 Bloodstream infections
K1 Extended-spectrum β-lactamase–producing Enterobacteriaceae
K1 Therapy
AB There is little information about the efficacy of active alternative drugs to carbapenems except β-lactam/β-lactamase inhibitors for the treatment of bloodstream infections (BSIs) due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). The objective of this study was to assess the outcomes of patients with BSI due to ESBL-E who received empiric therapy with such drugs (other active drugs [OADs]) or carbapenems. A multinational retrospective cohort study of patients with BSI due to ESBL-E who received empiric treatment with OADs or carbapenems was performed. Cox regression including a propensity score for receiving OADs was performed to analyze 30-day all-cause mortality as main outcome. Clinical failure and length of stay were also analyzed. Overall, 335 patients were included; 249 received empiric carbapenems and 86 OADs. The most frequent OADs were aminoglycosides (43 patients) and fluoroquinolones (20 patients). Empiric therapy with OADs was not associated with mortality (hazard ratio [HR], 0.75; 95% confidence interval [CI], .38-1.48) in the Cox regression analysis. Propensity score-matched pairs, subgroups, and sensitivity analyses did not show different trends; specifically, the adjusted HR for aminoglycosides was 1.05 (95% CI, .51-2.16). OADs were neither associated with 14-day clinical failure (adjusted odds ratio, 0.62; 95% CI, .29-1.36) nor length of hospital stay. We were unable to show that empiric treatment with OAD was associated with a worse outcome compared with carbapenems. This information allows more options to be considered for empiric therapy, at least for some patients, depending on local susceptibility patterns of ESBL-E.
PB Oxford University Press
YR 2017
FD 2017-07-13
LK http://hdl.handle.net/10668/11669
UL http://hdl.handle.net/10668/11669
LA en
NO Palacios-Baena ZR, Gutiérrez-Gutiérrez B, Calbo E, Almirante B, Viale P, Oliver A, et al. Empiric Therapy With Carbapenem-Sparing Regimens for Bloodstream Infections due to Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Results From the INCREMENT Cohort. Clin Infect Dis. 2017 Oct 30;65(10):1615-1623
DS RISalud
RD Apr 11, 2025