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

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dc.contributor.authorGutiérrez-Gutiérrez, Belén
dc.contributor.authorBonomo, Robert
dc.contributor.authorCarmel, Yehuda
dc.contributor.authorPaterson, David L.
dc.contributor.authorAlmirante, Benito
dc.contributor.authorMartínez-Martínez, Luis
dc.contributor.authorOliver, Antonio
dc.contributor.authorCalbo, Esther
dc.contributor.authorPeña, Carmen
dc.contributor.authorAkova, Murat
dc.contributor.authorPitou, Johann
dc.contributor.authorOrigüen, Julia
dc.contributor.authorPintado, Vicente
dc.contributor.authorGarcía-Vázquez, Elisa
dc.contributor.authorGasch, Oriol
dc.contributor.authorHamprecht, Axel
dc.contributor.authorPrim, Nuria
dc.contributor.authorTumbarello, Mario
dc.contributor.authorBou, German
dc.contributor.authorViale, Pierluigi
dc.contributor.authorTacconelli, Evelina
dc.contributor.authorAlmela, Manel
dc.contributor.authorPérez, Federico
dc.contributor.authorGiamarellou, Helen
dc.contributor.authorCisneros, José Miguel
dc.contributor.authorSchwabe, Mitchell J.
dc.contributor.authorVenditti, Mario
dc.contributor.authorLowman, Warren
dc.contributor.authorBermejo, Joaquín
dc.contributor.authorHsueh, Po-Ren
dc.contributor.authorMora-Rillo, Marta
dc.contributor.authorGracia-Ahulfinger, Irene
dc.contributor.authorPascual, Álvaro
dc.contributor.authorRodríguez-Baño, Jesús
dc.contributor.authorEIPI/ESGBIS/INCREMENT Group
dc.contributor.departmentMedicina
dc.date.accessioned2024-06-27T08:25:32Z
dc.date.available2024-06-27T08:25:32Z
dc.date.issued2015-12-26
dc.description©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/dkv502es
dc.description.abstractObjectives: 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 shockes
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dc.format.extent9es
dc.identifier.citationJournal of Antimicrobial Chemotherapy 2016 71: 1672 –1680
dc.identifier.doihttps://doi.org/10.1093/jac/dkv502
dc.identifier.issnPrint: 0305-7453
dc.identifier.issnElectronic: 1460-2091
dc.identifier.urihttp://hdl.handle.net/10201/142719
dc.languageenges
dc.publisherOxford University Presses
dc.relationThis study was funded by the Ministerio de Economı´a y Competitividad, Instituto de Salud Carlos III - co-financed by European Development Regional Fund ‘A way to achieve Europe’ ERDF, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015) and FIS (PI10/02021). The study was also supported in part by funds and/or facilities provided by the Cleveland Department of Veterans Affairs, the Veterans Affairs Merit Review Program and the Geriatric Research Education and Clinical Center VISN 10 (VISN 10 GRECC) to R. A. B. The NIAID of the NIH under Award Numbers R01AI072219 and R01AI063517 also sup- ported R. A. B.es
dc.relation.publisherversionhttps://academic.oup.com/jac/article/71/6/1672/1750458es
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.titleErtapenem for the treatment of bloodstream infections due to ESBL-producing Enterobacteriaceae: a multinational pre-registered cohort studyes
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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