Gutierrez-Gutierrez, Belen, Bonomo, Robert A., Carmeli, Yehuda, Paterson, David L., Almirante, Benito ORCID: 0000-0002-1189-2361, Martinez-Martinez, Luis, Oliver, Antonio ORCID: 0000-0001-9327-1894, Calbo, Esther ORCID: 0000-0001-7750-5347, Pena, Carmen, Akova, Murat, Pitout, Johann, Origuen, Julia ORCID: 0000-0002-6507-0363, Pintado, Vicente, Garcia-Vazquez, Elisa, Gasch, Oriol ORCID: 0000-0001-8518-458X, Hamprecht, Axel ORCID: 0000-0003-1449-5780, Prim, Nuria, Tumbarello, Mario ORCID: 0000-0002-9519-8552, Bou, German ORCID: 0000-0001-8837-0062, Viale, Pierluigi, Tacconelli, Evelina, Almela, Manel, Perez, Federico, Giamarellou, Helen, Miguel Cisneros, Jose, Schwaber, Mitchell J., Venditti, Mario, Lowman, Warren ORCID: 0000-0002-6981-389X, Bermejo, Joaquin, Hsueh, Po-Ren, Mora-Rillo, Marta ORCID: 0000-0002-2735-5931, Gracia-Ahulfinger, Irene, Pascual, Alvaro ORCID: 0000-0002-8672-5891 and Rodriguez-Bano, Jesus ORCID: 0000-0001-6732-9001 (2016). Ertapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: a multinational pre-registered cohort study. J. Antimicrob. Chemother., 71 (6). S. 1672 - 1681. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

Full text not available from this repository.

Abstract

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 (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 (0.442.50; 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. 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Gutierrez-Gutierrez, BelenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonomo, Robert A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carmeli, YehudaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paterson, David L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Almirante, BenitoUNSPECIFIEDorcid.org/0000-0002-1189-2361UNSPECIFIED
Martinez-Martinez, LuisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oliver, AntonioUNSPECIFIEDorcid.org/0000-0001-9327-1894UNSPECIFIED
Calbo, EstherUNSPECIFIEDorcid.org/0000-0001-7750-5347UNSPECIFIED
Pena, CarmenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Akova, MuratUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pitout, JohannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Origuen, JuliaUNSPECIFIEDorcid.org/0000-0002-6507-0363UNSPECIFIED
Pintado, VicenteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garcia-Vazquez, ElisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gasch, OriolUNSPECIFIEDorcid.org/0000-0001-8518-458XUNSPECIFIED
Hamprecht, AxelUNSPECIFIEDorcid.org/0000-0003-1449-5780UNSPECIFIED
Prim, NuriaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tumbarello, MarioUNSPECIFIEDorcid.org/0000-0002-9519-8552UNSPECIFIED
Bou, GermanUNSPECIFIEDorcid.org/0000-0001-8837-0062UNSPECIFIED
Viale, PierluigiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tacconelli, EvelinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Almela, ManelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Perez, FedericoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giamarellou, HelenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miguel Cisneros, JoseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schwaber, Mitchell J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Venditti, MarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lowman, WarrenUNSPECIFIEDorcid.org/0000-0002-6981-389XUNSPECIFIED
Bermejo, JoaquinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hsueh, Po-RenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mora-Rillo, MartaUNSPECIFIEDorcid.org/0000-0002-2735-5931UNSPECIFIED
Gracia-Ahulfinger, IreneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pascual, AlvaroUNSPECIFIEDorcid.org/0000-0002-8672-5891UNSPECIFIED
Rodriguez-Bano, JesusUNSPECIFIEDorcid.org/0000-0001-6732-9001UNSPECIFIED
URN: urn:nbn:de:hbz:38-274570
DOI: 10.1093/jac/dkv502
Journal or Publication Title: J. Antimicrob. Chemother.
Volume: 71
Number: 6
Page Range: S. 1672 - 1681
Date: 2016
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1460-2091
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LACTAMASE-PRODUCING ENTEROBACTERIACEAE; SPECTRUM BETA-LACTAMASES; ESCHERICHIA-COLI; PSEUDOMONAS-AERUGINOSA; KLEBSIELLA-PNEUMONIAE; CARBAPENEM THERAPY; SUSCEPTIBILITY; BACTEREMIA; PHARMACOKINETICS; IMIPENEMMultiple languages
Infectious Diseases; Microbiology; Pharmacology & PharmacyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/27457

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item