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Carbapenems Versus Piperacillin-Tazobactam for Bloodstream Infections of Nonurinary Source Caused by Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae

  • Hadas Ofer-Friedman (a1), Coral Shefler (a2), Sarit Sharma (a3), Amit Tirosh (a4), Ruthy Tal-Jasper (a2), Deepthi Kandipalli (a3), Shruti Sharma (a3), Pradeep Bathina (a3), Tamir Kaplansky (a1), Moran Maskit (a1), Tal Azouri (a1), Tsilia Lazarovitch (a5), Ronit Zaidenstein (a4), Keith S. Kaye (a3) and Dror Marchaim (a1) (a2)...

Abstract

A recent, frequently quoted study has suggested that for bloodstream infections (BSIs) due to extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL) Escherichia coli, treatment with β-lactam/β-lactamase inhibitors (BLBLIs) might be equivalent to treatment with carbapenems. However, the majority of BSIs originate from the urinary tract. A multicenter, multinational efficacy analysis was conducted from 2010 to 2012 to compare outcomes of patients with non-urinary ESBL BSIs who received a carbapenem (69 patients) vs those treated with piperacillin-tazobactam (10 patients). In multivariate analysis, therapy with piperacillin-tazobactam was associated with increased 90-day mortality (adjusted odds ratio, 7.9, P=.03). For ESBL BSIs of a non-urinary origin, carbapenems should be considered a superior treatment to BLBLIs.

Infect Control Hosp Epidemiol 2015;36(8):981–985

Copyright

Corresponding author

Address correspondence to Dror Marchaim, MD, Unit of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin, 70300, Israel (drormarchaim@gmail.com).

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Hadas Ofer-Friedman and Coral Shefler contributed equally to this publication.

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References

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Carbapenems Versus Piperacillin-Tazobactam for Bloodstream Infections of Nonurinary Source Caused by Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae

  • Hadas Ofer-Friedman (a1), Coral Shefler (a2), Sarit Sharma (a3), Amit Tirosh (a4), Ruthy Tal-Jasper (a2), Deepthi Kandipalli (a3), Shruti Sharma (a3), Pradeep Bathina (a3), Tamir Kaplansky (a1), Moran Maskit (a1), Tal Azouri (a1), Tsilia Lazarovitch (a5), Ronit Zaidenstein (a4), Keith S. Kaye (a3) and Dror Marchaim (a1) (a2)...

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