دورية أكاديمية
Empirical cefepime plus vancomycin versus ceftazidime plus vancomycin versus meropenem plus vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter ephesus study
| العنوان: | Empirical cefepime plus vancomycin versus ceftazidime plus vancomycin versus meropenem plus vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter ephesus study |
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| المؤلفون: | Akyol, Deniz, Sipahi, Oğuz Reşat, Örmen, Bahar, Çicek-Şentürk, Gönül, Mermer, Sinan, Önal, Uğur, Amer, Fatma |
| بيانات النشر: | Bmc |
| سنة النشر: | 2023 |
| المجموعة: | Ege University Institutional Repository |
| مصطلحات موضوعية: | Empirical therapy, Healthcare-associated meningitis, Multicenter study, Glycopeptides, Antibiotics, Nosocomial Bacterial-Meningitis, Resistant Staphylococcus-Aureus, Practice Guidelines, Clinical-Features, Management, Adults, Ventriculitis, Series |
| الوصف: | Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM).Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018.Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p 0.05). Microbiological success on Day 3-5, end of treatment (EOT) clinical success (80% vs. 54.8%% vs 57.9%), and overall success (EOT success followed by one-month survival without relapse or reinfection 65% vs. 51.6% vs. 45.3%), EOT all cause mortality (ACM) and day 30 ACM (15% vs. 22.6% vs. 26%) did not differ significantly (p > 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34).Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1471-2334 |
| العلاقة: | Bmc Infectious Diseases; Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı; https://hdl.handle.net/11454/92207Test; https://doi.org/10.1186/s12879-023-08596-zTest; 23 |
| DOI: | 10.1186/s12879-023-08596-z |
| الإتاحة: | https://doi.org/10.1186/s12879-023-08596-zTest https://hdl.handle.net/11454/92207Test |
| حقوق: | open |
| رقم الانضمام: | edsbas.DD505AAE |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 14712334 |
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| DOI: | 10.1186/s12879-023-08596-z |