التفاصيل البيبلوغرافية
| العنوان: |
Efficacy of carbapenem vs non carbapenem β-lactam therapy as empiric antimicrobial therapy in patients with extended-spectrum β-lactamase-producing Enterobacterales urinary septic shock: a propensity-weighted multicenter cohort study. |
| المؤلفون: |
Cariou, Erwann, Griffier, Romain, Orieux, Arthur, Silva, Stein, Faguer, Stanislas, Seguin, Thierry, Nseir, Saad, Canet, Emmanuel, Desclaux, Arnaud, Souweine, Bertrand, Klouche, Kada, Guisset, Olivier, Pillot, Jerome, Picard, Walter, Saghi, Tahar, Delobel, Pierre, Gruson, Didier, Prevel, Renaud, Boyer, Alexandre |
| المصدر: |
Annals of Intensive Care; 3/24/2023, Vol. 13 Issue 1, p1-11, 11p |
| مصطلحات موضوعية: |
SEPTIC shock, COHORT analysis, CLOSTRIDIOIDES difficile, URINARY tract infections, DISEASE relapse |
| مستخلص: |
Background: The rise in antimicrobial resistance is a global threat responsible for about 33,000 deaths in 2015 with a particular concern for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and has led to a major increase in the use of carbapenems, last-resort antibiotics. Methods: In this retrospective propensity-weighted multicenter observational study conducted in 11 ICUs, the purpose was to assess the efficacy of non carbapenem regimen (piperacillin–tazobactam (PTZ) + aminoglycosides or 3rd-generation cephalosporin (3GC) + aminoglycosides) as empiric therapy in comparison with carbapenem in extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) urinary septic shock. The primary outcome was Day-30 mortality. Results: Among 156 patients included in this study, 69 received a carbapenem and 87 received non carbapenem antibiotics as empiric treatment. Baseline clinical characteristics were similar between the two groups. Patients who received carbapenem had similar Day-30 mortality (10/69 (15%) vs 6/87 (7%), OR = 1.99 [0.55; 5.34] p = 0.16), illness severity, resolution of septic shock, and ESBL-E infection recurrence rates than patients who received an empiric non carbapenem therapy. The rates of secondary infection with C. difficile were comparable. Conclusions: In ESBL-E urinary septic shock, empiric treatment with a non carbapenem regimen, including systematically aminoglycosides, was not associated with higher mortality, compared to a carbapenem regimen. [ABSTRACT FROM AUTHOR] |
|
Copyright of Annals of Intensive Care is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder