Reply: The Efficacy of Penicillins with β-lactamase Inhibitor or Cefmetazole against Pneumonia in which ESBL-Producing Bacteria were Isolated from Sputum
Abstract
We read with interest the recent paper by Goto et al.[1], which discussed the efficacy of penicillins with β-lactamase inhibitor or cefmetazole against pneumonia in which extended spectrum β-lactamase (ESBL)-producing bacteria were isolated from sputum. Carbapenems are considered the drugs of choice for treating such infections. However, increased empirical use of carbapenems in response to an increased prevalence of ESBL-producing isolates may be accompanied by the rapid emergence of carbapenem resistance in other pathogens [2]. Therefore, therapeutic options other than carbapenems would be attractive. Several observational studies have suggested that beta-lactam/beta-lactamase inhibitors (BL/BLIs) may be clinically effective for treating infections caused by ESBL producers [2-5]. A more prudent use of carbapenems as the initial empirical antibiotic may be reasonable in suspected Gram-negative bacteremia.
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