Gutierrez-Gutierrez, BelenBonomo, Robert ACarmeli, YehudaPaterson, David LAlmirante, BenitoMartinez-Martinez, LuisOliver, AntonioCalbo, EstherPeña, CarmenAkova, MuratPitout, JohannOrigüen, JuliaPintado, VicenteGarcia-Vazquez, ElisaGasch, OriolHamprecht, AxelPrim, NuriaTumbarello, MarioBou, GermanViale, PierluigiTacconelli, EvelinaAlmela, ManelPerez, FedericoGiamarellou, HelenCisneros, Jose MiguelSchwaber, Mitchell JVenditti, MarioLowman, WarrenBermejo, JoaquinHsueh, Po-RenMora-Rillo, MartaGracia-Ahulfinger, IrenePascual, AlvaroRodriguez-Baño, Jesus2023-01-252023-01-252015-12-26Gutiérrez-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):1672-80http://hdl.handle.net/10668/9859Data 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.enAnti-bacterial agentsCarbapenemsEnterobacteriaceaeEnterobacteriaceae infectionsAgedErtapenemFemaleHumansMaleMiddle agedRetrospective studiesSepsisSurvival analysisTreatment outcomebeta-lactamasesbeta-lactamsresearch article26907184open accessAnálisis de supervivenciaErtapenemResultado del tratamientoSepsisbeta-Lactamas10.1093/jac/dkv5021460-2091PMC4867097https://academic.oup.com/jac/article-pdf/71/6/1672/13760703/dkv502.pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867097/pdf