WANG-DA LIUShih M.-C.YU-CHUNG CHUANGJANN-TAY WANGWANG-HUEI SHENG2020-12-292020-12-2920191684-1182https://www.scopus.com/inward/record.uri?eid=2-s2.0-85066257872&doi=10.1016%2fj.jmii.2019.04.008&partnerID=40&md5=ba8738d0752c3495c86c5ddc58b792b1https://scholars.lib.ntu.edu.tw/handle/123456789/535199Background: Doripenem shows good in vitro activity against common nosocomial pathogens, such as extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii. However, the use of doripenem for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remains controversial. The aim of this study was to compare the efficacy and safety between doripenem and meropenem for patients with HAP or VAP. Methods: Adult patients diagnosed with HAP and VAP at National Taiwan University Hospital, who received doripenem or meropenem for more than 48 h between January 2015 and November 2017, were retrospectively reviewed. All-cause mortality on the 30th day was used as the primary outcome measurements. Results: Fifty-seven patients with doripenem and 252 patients with meropenem were analyzed. Compared to the meropenem group, the doripenem group was younger and had a higher Sequential Organ Failure Assessment (SOFA) score. Multivariable Cox regression analysis revealed that presence of solid organ malignancies (adjusted hazard ratio [AHR], 1.82; 95% CI, 1.04–3.19, p = 0.003) and SOFA score (AHR, 1.10; 95% CI, 1.03–1.17, p = 0.003) were independent factors associated with mortality. There was no survival difference of 30-day mortality between patients receiving doripenem and meropenem for HAP or VAP (log-rank p = 0.113). However, a poorer outcome was observed among patients with hematological disease in the doripenem group (log-rank p = 0.012). Conclusion: Our results demonstrate that doripenem has similar efficacy as meropenem in HAP or VAP patients. With an aim to enhance antibiotic diversity, doripenem could be an alternative choice for patients with HAP or VAP, except for those with hematological malignancies. ? 2019[SDGs]SDG3cephalosporin; cilastatin plus imipenem; doripenem; imipenem; meropenem; piperacillin plus tazobactam; antiinfective agent; doripenem; meropenem; adult; aged; all cause mortality; anaphylaxis; angioneurotic edema; antibiotic therapy; antimicrobial stewardship; Article; blood culture; comparative effectiveness; controlled study; drug efficacy; drug safety; drug substitution; drug withdrawal; female; follow up; hospital acquired pneumonia; human; major clinical study; male; outcome assessment; retrospective study; Sequential Organ Failure Assessment Score; Stevens Johnson syndrome; toxic epidermal necrolysis; treatment duration; ventilator associated pneumonia; very elderly; Acinetobacter baumannii; cross infection; drug effect; hospital; microbial sensitivity test; microbiology; middle aged; multidrug resistance; multivariate analysis; Pseudomonas aeruginosa; regression analysis; Taiwan; ventilator associated pneumonia; Acinetobacter baumannii; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cross Infection; Doripenem; Drug Resistance, Multiple, Bacterial; Female; Hospitals; Humans; Male; Meropenem; Microbial Sensitivity Tests; Middle Aged; Multivariate Analysis; Pneumonia, Ventilator-Associated; Pseudomonas aeruginosa; Regression Analysis; Retrospective Studies; Taiwanjournal article10.1016/j.jmii.2019.04.00831155463