Carbapenem-Sparing Therapy for Extended-Spectrum β-Lactamase-Producing E coli and Klebsiella pneumoniae Bloodstream Infection: The Search Continues
Abstract
Bloodstream infections due to Escherichia coli and Klebsiella pneumoniae are associated with significant morbidity, mortality, and financial costs.1 Resistance to third-generation cephalosporins is increasing in these species both in the community and in health care settings.2 The most common mechanism of third-generation cephalosporin resistance is production of an extendedspectrum β-lactamase (ESBL).3 These enzymes render E coli and K pneumoniae nonsusceptible to nearly all cephalosporins and penicillins. Carbapenems, such as meropenem, remain active and are considered preferred agents for treatment of bloodstream infections due to ESBL-producing organisms. However, treatment with carbapenems creates selective pressure for development of carbapenem resistance, which is arguably the greatest contemporary antibiotic resistance threat. Thus, there is intense interest both in the development of new antibiotics and in the reassessment of older antibiotics for use as carbapenem alternatives. By definition, ESBLs are inhibited by β-lactamase inhibitors such as clavulanate and tazobactam. Because of this characteristic, β-lactam/β-lactamase inhibitors (BLBLIs) have been evaluated in several observational studies as carbapenem-sparing therapy for ESBL-producing bacterial infection. Results of these studies have been conflicting. In a large multinational cohort study, 30-day mortality was similar in patients with ESBL-producing bacteremia who were treated with either a BLBLI or a…
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Levofloxacin-Induced Tendon Rupture: A Case Report and Review of the Literature
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Quality evaluation and in vitro interaction studies between levofloxacin 250mg and diclofenac sodium 50mg tablets
- Molecular Epidemiology of mcr-1 -Positive Polymyxin B-Resistant Escherichia coli Producing Extended-Spectrum β-Lactamase (ESBL) in a Tertiary Hospital in Shandong, China
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.