Annals of the Academy of Medicine, Singapore · 2008
Ertapenem for treatment of extended-spectrum beta-lactamase-producing and multidrug-resistant gram-negative bacteraemia.
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Lye David Chien, Wijaya Limin, Chan Joey, Teng Chew Ping, Leo Yee Sin
Аннотация
INTRODUCTION: Imipenem and meropenem are treatment of choice for extended-spectrum betalactamase (ESBL)-positive gram-negative bacteraemia. They may select for carbapenemresistant Acinetobacter baumannii and Pseudomonas aeruginosa; ertapenem may not do so as it is inactive against these bacteria. Clinical efficacy of ertapenem in ESBL-producing gramnegative bacteraemia is limited.
MATERIALS AND METHODS: Retrospective study of patients with ESBL-positive gram-negative bacteraemia treated with ertapenem was undertaken.
RESULTS: Forty-seven patients with multidrug-resistant gram-negative bacteraemia (79% produced ESBL) were treated with ertapenem for a median duration of 11 days. The median age was 70 years. Septic shock occurred in 19% and mechanical ventilation was needed in 17%. Klebsiella pneumoniae comprised 53% and Escherichia coli 26%. Urinary infection accounted for 61% and hepatobiliary 15%. Favourable clinical response occurred in 96%. Attributable mortality was 4%.
CONCLUSION: Ertapenem is promising in culture-guided step-down therapy of ESBL-positive gram-negative bacteraemia.
MATERIALS AND METHODS: Retrospective study of patients with ESBL-positive gram-negative bacteraemia treated with ertapenem was undertaken.
RESULTS: Forty-seven patients with multidrug-resistant gram-negative bacteraemia (79% produced ESBL) were treated with ertapenem for a median duration of 11 days. The median age was 70 years. Septic shock occurred in 19% and mechanical ventilation was needed in 17%. Klebsiella pneumoniae comprised 53% and Escherichia coli 26%. Urinary infection accounted for 61% and hepatobiliary 15%. Favourable clinical response occurred in 96%. Attributable mortality was 4%.
CONCLUSION: Ertapenem is promising in culture-guided step-down therapy of ESBL-positive gram-negative bacteraemia.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAnti-Bacterial AgentsBacteremiaDrug Resistance, Multiple, BacterialErtapenemEscherichia coliEscherichia coli InfectionsFemaleGram-Negative BacteriaGram-Negative Bacterial InfectionsHumansKlebsiella InfectionsKlebsiella pneumoniaeMaleMicrobial Sensitivity TestsMiddle AgedRetrospective StudiesUrinary Tract Infectionsbeta-Lactamasesbeta-Lactams