Clinical comparison of ertapenem and cefepime for treatment of infections caused by AmpC beta-lactamase-producing Enterobacteriaceae.

Lisa M Blanchette, Joseph L Kuti, David P Nicolau, Michael D Nailor
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引用次数: 20

Abstract

There are no comparative data evaluating outcomes of ertapenem treatment for infections with AmpC-producing Enterobacteriaceae. This retrospective matched case-control study was conducted between 2009 and 2012. Sixteen cases treated with ertapenem were matched 1:2 with 32 control cases treated with cefepime based on age, culture source, and hospital service. There were more cefepime-resistant organisms in the ertapenem group (cefepime resistance present in 44% of patients treated with ertapenem compared with 0% of control patients, p < 0.001). Ertapenem was used empirically in 25% of patients compared with 88% who received cefepime empirically (p < 0.001). Consequently, 56% of patients on ertapenem received inappropriate initial therapy compared with 9% of patients on cefepime (p < 0.001). No differences in clinical success were identified (69% for ertapenem vs 88% for cefepime, p = 0.138). Although a trend favoring cefepime could be suspected, it should be noted that no statistically significant difference in clinical success was detected despite the presence of more resistant organisms and delays in initiation of appropriate therapy among patients receiving ertapenem.

厄他培南与头孢吡肟治疗产AmpC内酰胺酶肠杆菌科感染的临床比较。
尚无比较数据评估厄他培南治疗产ampc肠杆菌科感染的结果。本回顾性匹配病例对照研究于2009年至2012年进行。依他培南16例与头孢吡肟32例对照,按年龄、培养源、医院服务情况进行1:2匹配。厄他培南组有更多的头孢吡肟耐药菌(接受厄他培南治疗的患者中有44%对头孢吡肟耐药,对照组为0%,p < 0.001)。25%的患者经验性使用厄他培南,而88%的患者经验性使用头孢吡肟(p < 0.001)。因此,56%的厄他培南患者接受了不适当的初始治疗,而9%的头孢吡肟患者接受了不适当的初始治疗(p < 0.001)。临床成功率无差异(厄他培南为69%,头孢吡肟为88%,p = 0.138)。虽然可能怀疑有偏向头孢吡肟的趋势,但应该注意的是,尽管在接受厄他培南的患者中存在更多耐药菌和延迟开始适当治疗,但临床成功率没有统计学上的显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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