Ertapenem for treatment of extended-spectrum beta-lactamase-producing and multidrug-resistant gram-negative bacteraemia
Annals of the Academy of Medicine, Singapore
;
: 831-834, 2008.
Article
in English
| WPRIM
| ID: wpr-244483
ABSTRACT
<p><b>INTRODUCTION</b>Imipenem and meropenem are treatment of choice for extended-spectrum betalactamase (ESBL)-positive gram-negative bacteraemia. They may select for carbapenemresistant Acinetobacter baumannii and Pseudomonas aeruginosa; ertapenem may not do so as it is inactive against these bacteria. Clinical efficacy of ertapenem in ESBL-producing gramnegative bacteraemia is limited.</p><p><b>MATERIALS AND METHODS</b>Retrospective study of patients with ESBL-positive gram-negative bacteraemia treated with ertapenem was undertaken.</p><p><b>RESULTS</b>Forty-seven patients with multidrug-resistant gram-negative bacteraemia (79% produced ESBL) were treated with ertapenem for a median duration of 11 days. The median age was 70 years. Septic shock occurred in 19% and mechanical ventilation was needed in 17%. Klebsiella pneumoniae comprised 53% and Escherichia coli 26%. Urinary infection accounted for 61% and hepatobiliary 15%. Favourable clinical response occurred in 96%. Attributable mortality was 4%.</p><p><b>CONCLUSION</b>Ertapenem is promising in culture-guided step-down therapy of ESBL-positive gram-negative bacteraemia.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pharmacology
/
Urinary Tract Infections
/
Beta-Lactamases
/
Klebsiella Infections
/
Microbial Sensitivity Tests
/
Retrospective Studies
/
Gram-Negative Bacterial Infections
/
Bacteremia
/
Drug Resistance, Multiple, Bacterial
/
Therapeutic Uses
Type of study:
Observational study
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2008
Type:
Article
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