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https://doi.org/10.1093/jac/dkv502
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Título: | Ertapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: a multinational pre-registered cohort study |
Fecha de publicación: | 26-dic-2015 |
Editorial: | Oxford University Press |
Cita bibliográfica: | Journal of Antimicrobial Chemotherapy 2016; 71: 1672 –1680 |
ISSN: | Print: 0305-7453 Electronic: 1460-2091 |
Resumen: | Objectives: 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. Methods: 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. Results: 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 (P¼0.06) in the ETC and 89.8% and 82.6% (P ¼ 0.02) in the TTC, respectively; 30 day mortality rates were 3.1% and 23.3% (P¼0.01) in the ETC and 9.3% and 17.1% (P¼0.01) in the TTC, respectively. Adjusted ORs (95% CI) forcure/improvement with empirical and targeted ertapenem were 1.87 (0.24 – 20.08; P ¼0.58) and 1.04 (0.44 – 2.50; P ¼ 0.92), respectively. For the propensity-matched cohorts it was 1.18 (0.43 – 3.29; P¼ 0.74). Regarding 30 day mortality, the adjusted HR (95% CI) for targeted ertapenem was 0.93 (0.43 –2.03; P¼0.86) and for the propensity-matched cohorts it was 1.05 (0.46 – 2.44; P ¼0.90). Sensitivity analyses were consistent except for patients with severe sepsis/septic shock, which showed a non-significant trend favouring other carbapenems. Conclusions: 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 |
Autor/es principal/es: | Gutiérrez-Gutiérrez, Belén Bonomo, Robert Carmel, Yehuda Paterson, David L. Almirante, Benito Martínez-Martínez, Luis Oliver, Antonio Calbo, Esther Peña, Carmen Akova, Murat Pitou, Johann Origüen, Julia Pintado, Vicente García-Vázquez, Elisa Gasch, Oriol Hamprecht, Axel Prim, Nuria Tumbarello, Mario Bou, German Viale, Pierluigi Tacconelli, Evelina Almela, Manel Pérez, Federico Giamarellou, Helen Cisneros, José Miguel Schwabe, Mitchell J. Venditti, Mario Lowman, Warren Bermejo, Joaquín Hsueh, Po-Ren Mora-Rillo, Marta Gracia-Ahulfinger, Irene Pascual, Álvaro Rodríguez-Baño, Jesús EIPI/ESGBIS/INCREMENT Group |
Facultad/Departamentos/Servicios: | Facultades, Departamentos, Servicios y Escuelas::Departamentos de la UMU::Medicina Interna |
Versión del editor: | https://academic.oup.com/jac/article/71/6/1672/1750458 |
URI: | http://hdl.handle.net/10201/142719 |
DOI: | https://doi.org/10.1093/jac/dkv502 |
Tipo de documento: | info:eu-repo/semantics/article |
Número páginas / Extensión: | 9 |
Derechos: | info:eu-repo/semantics/embargoedAccess |
Descripción: | ©2016 The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. This document is the Published, version of a Published Work that appeared in final form in Journal of Antimicrobial Chemotherapy. To access the final edited and published work see https://doi.org/10.1093/jac/dkv502 |
Aparece en las colecciones: | Artículos: Medicina |
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