Por favor, use este identificador para citar o enlazar a este item:
http://hdl.handle.net/10261/214623
COMPARTIR / EXPORTAR:
SHARE CORE BASE | |
Visualizar otros formatos: MARC | Dublin Core | RDF | ORE | MODS | METS | DIDL | DATACITE | |
Título: | Non-intravenous carbapenem-sparing antibiotics for definitive treatment of bacteraemia due to Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBL) or AmpC beta-lactamase: A propensity score study |
Autor: | Meije, Yolanda; Pigrau, Carlos; Fernández-Hidalgo, N.; Clemente, Mercedes; Ortega, Lucía; Sanz, Xavier; Loureiro-Amigo, Jose; Sierra, Montserrat; Ayestarán, Ana; Morales-Cartagena, Alejandra; Ribera, A.; Duarte, Alejandra; Abelenda, Gabriela; Rodríguez-Baño, Jesús CSIC ORCID; Martínez-Montauti, Joaquim | Palabras clave: | Carbapenem-sparing antibiotics Enterobacteriaceae bacteraemia Stewardship Extended-spectrum β-lactamase AmpC β-lactamases Trimethoprim/sulfamethoxazole |
Fecha de publicación: | ago-2019 | Editor: | Elsevier | Citación: | International Journal of Antimicrobial Agents 54(2): 189-196 (2019) | Resumen: | Carbapenems are considered the treatment of choice for extended-spectrum β-lactamase (ESBL)- or AmpC β-lactamase-producing Enterobacteriaceae bacteraemia. Data on the effectiveness of non-intravenous carbapenem-sparing antibiotic options are limited. This study compared the 30-day mortality and clinical failure associated with the use of carbapenems versus alternative non-intravenous antibiotics for the definitive treatment of ESBL/AmpC-positive Enterobacteriaceae bacteraemia. This 12-year retrospective study (2004–2015) included all patients with bacteraemia due to ESBL/AmpC-producing Enterobacteriaceae at a Spanish hospital. Given the lack of randomisation of initial therapies, a propensity score for receiving carbapenems was calculated. There were 1115 patients with a first episode of bacteraemia due to Escherichia coli or Klebsiella pneumoniae, of which 123 (11.0%) were ESBL/AmpC-positive. There were 101 eligible patients: 59 in the carbapenem group and 42 in the alternative treatment group (trimethoprim/sulfamethoxazole 59.5%, quinolones 21.4%). The most frequent sources of infection were urinary (63%) and biliary (15%). Compared with the carbapenem group, patients treated with an alternative regimen had a shorter hospital stay [median (IQR) 7 (5–10) days vs. 12 (9–18) days; P < 0.001]. Use of an alternative non-intravenous therapy did not increase mortality (OR = 0.27, 95% CI 0.05–1.61; P = 0.15). After controlling for confounding factors with the propensity score, the adjusted OR of carbapenem treatment was 4.95 (95% CI 0.94–26.01; P = 0.059). Alternative non-intravenous carbapenem-sparing antibiotics could have a role in the definitive treatment of ESBL/AmpC-positive Enterobacteriaceae bacteraemia, allowing a reduction in carbapenem use. Use of trimethoprim/sulfamethoxazole in this series showed favourable results. | Versión del editor: | http://dx.doi.org/10.1016/j.ijantimicag.2019.05.004 | URI: | http://hdl.handle.net/10261/214623 | DOI: | 10.1016/j.ijantimicag.2019.05.004 | ISSN: | 0924-8579 | E-ISSN: | 1872-7913 |
Aparece en las colecciones: | (IBIS) Artículos |
Ficheros en este ítem:
Fichero | Descripción | Tamaño | Formato | |
---|---|---|---|---|
accesoRestringido.pdf | 15,38 kB | Adobe PDF | Visualizar/Abrir |
CORE Recommender
SCOPUSTM
Citations
16
checked on 09-may-2024
WEB OF SCIENCETM
Citations
13
checked on 24-feb-2024
Page view(s)
117
checked on 21-may-2024
Download(s)
26
checked on 21-may-2024
Google ScholarTM
Check
Altmetric
Altmetric
NOTA: Los ítems de Digital.CSIC están protegidos por copyright, con todos los derechos reservados, a menos que se indique lo contrario.