Details

Autor(en) / Beteiligte

• Gutiérrez-Gutiérrez, Belén
• Bonomo, Robert A
• Carmeli, Yehuda
• Paterson, David L
• Almirante, Benito
• Martínez-Martínez, Luis
• Oliver, Antonio
• Calbo, Esther
• Peña, Carmen
• Akova, Murat
• Pitout, 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
• Schwaber, Mitchell J
• Venditti, Mario
• Lowman, Warren
• Bermejo, Joaquín
• Hsueh, Po-Ren
• Mora-Rillo, Marta
• Gracia-Ahulfinger, Irene
• Pascual, Alvaro
• Rodríguez-Baño, Jesús

Titel

Ertapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: a multinational pre-registered cohort study

Ist Teil von

• Journal of antimicrobial chemotherapy, 2016-06, Vol.71 (6), p.1672-1680

Ort / Verlag

England: Oxford Publishing Limited (England)

Erscheinungsjahr

2016

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• 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.