دورية أكاديمية
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
| 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 |
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| 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, Jérôme, Picard, Walter, Saghi, Tahar, Delobel, Pierre, Gruson, Didier, Prével, Renaud, Boyer, Alexandre |
| المساهمون: | Centre Hospitalier Universitaire de Bordeaux (CHU de Bordeaux), Santé publique, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche Cardio-Thoracique de Bordeaux Bordeaux (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Département de Néphrologie et Transplantation d'organes CHU Toulouse, Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques CHU Toulouse, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Faculté de Médecine Rangueil, Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille), Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes), Service de médecine interne et maladies tropicales, CHU Bordeaux-Groupe hospitalier Saint-André, CHU Gabriel Montpied Clermont-Ferrand, CHU Clermont-Ferrand, Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), CHU Montpellier, Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Centre Hospitalier de la Côte Basque (CHCB), Centre hospitalier de Pau, Polyclinique Bordeaux Nord Aquitaine (PBNA), Service Maladies infectieuses et tropicales CHU Toulouse, Pôle Inflammation, infection, immunologie et loco-moteur CHU Toulouse (Pôle I3LM Toulouse) |
| المصدر: | ISSN: 2110-5820 ; Annals of Intensive Care ; https://hal.science/hal-04046566Test ; Annals of Intensive Care, 2023, 13 (1), pp.22. ⟨10.1186/s13613-023-01106-z⟩. |
| بيانات النشر: | HAL CCSD SpringerOpen |
| سنة النشر: | 2023 |
| المجموعة: | Université Toulouse III - Paul Sabatier: HAL-UPS |
| مصطلحات موضوعية: | Extended-spectrum β-lactamase-producing Enterobacterales, Non carbapenem β-lactam therapy, Antimicrobial resistance, Septic shock, Urinary tract infection, Aminoglycosides, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie |
| الوصف: | International audience ; Abstract 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. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | hal-04046566; https://hal.science/hal-04046566Test; https://hal.science/hal-04046566/documentTest; https://hal.science/hal-04046566/file/2023%20Cariou%20et%20al.,%20Efficacy%20of%20carbapenem%20vs%20non%20carbapenem%20%CE%B2.pdfTest |
| DOI: | 10.1186/s13613-023-01106-z |
| الإتاحة: | https://doi.org/10.1186/s13613-023-01106-zTest https://hal.science/hal-04046566Test https://hal.science/hal-04046566/documentTest https://hal.science/hal-04046566/file/2023%20Cariou%20et%20al.,%20Efficacy%20of%20carbapenem%20vs%20non%20carbapenem%20%CE%B2.pdfTest |
| حقوق: | http://creativecommons.org/licenses/byTest/ ; info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.64FD7009 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s13613-023-01106-z |
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