https://scholars.lib.ntu.edu.tw/handle/123456789/532753
標題: | Ertapenem in the treatment of bacteremia caused by extended-spectrum beta-lactamase-producing Escherichia coli: A propensity score analysis | 作者: | UN-IN WU Chen W.-C. Yang C.-S. Wang J.-L. Hu F.-C. SHAN-CHWEN CHANG YEE-CHUN CHEN |
公開日期: | 2012 | 卷: | 16 | 期: | 1 | 起(迄)頁: | e47-e52 | 來源出版物: | International Journal of Infectious Diseases | 摘要: | Objective: This study assessed the impact of ertapenem and other carbapenems on mortality in patients with monomicrobial extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) bacteremia. Methods: This non-concurrent prospective study included adult patients with ESBL-EC bacteremia during a 2.5-year period at a 2200-bed teaching hospital. We used a multivariate logistic regression model and Cox's proportional hazards model including propensity score analysis to assess variables associated with 30-day mortality. Results: Of 71 patients who met the study criteria, nine died within 3 days. Among the 62 remaining patients who received definitive antimicrobial therapy, 13 died within 30 days. Male gender, ICU stay, solid tumor, and primary bacteremia were independent predictors of 30-day mortality, whereas definitive antimicrobial therapy using either ertapenem or imipenem/meropenem was protective (p<0.001 and p=0.002, respectively). Adjustment by propensity score found that ertapenem appeared to exhibit more favorable outcomes, but the difference fell short of statistical significance (hazard ratio 0.02, p=0.06). Inappropriate initial therapy was not a significant predictor of mortality. Conclusions: ICU stay, but not initial choice of empirical antimicrobial therapy, was a major predictor of mortality. Using a carbapenem as definitive therapy was a protective factor for 30-day mortality. The choice of ertapenem is reasonable for less severely-ill patients who are at risk of ESBL-EC bacteremia and unlikely to have infection due to Pseudomonas aeruginosa. ? 2011 International Society for Infectious Diseases. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84855311401&doi=10.1016%2fj.ijid.2011.09.019&partnerID=40&md5=df81600c4bc02556dd13946ce8eac333 https://scholars.lib.ntu.edu.tw/handle/123456789/532753 |
ISSN: | 1201-9712 | DOI: | 10.1016/j.ijid.2011.09.019 | SDG/關鍵字: | carbapenem; ertapenem; imipenem; meropenem; aged; antimicrobial therapy; article; bacteremia; Escherichia coli; extended spectrum beta lactamase producing Enterobacteriaceae; female; hospitalization; human; intensive care unit; major clinical study; male; mortality; multivariate logistic regression analysis; nonhuman; propensity score; proportional hazards model; prospective study; Aged; Anti-Bacterial Agents; Bacteremia; beta-Lactamases; beta-Lactams; Carbapenems; Escherichia coli; Female; Humans; Imipenem; Male; Middle Aged; Propensity Score; Thienamycins |
顯示於: | 醫學系 |
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