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Efficacy of carbapenem vs non carbapenem beta-lactam therapy as empiric antimicrobial therapy in patients with extended-spectrum beta-lactamase-producing Enterobacterales urinary septic shock: a propensity-weighted multicenter cohort study

dc.rights.licenseopenen_US
dc.contributor.authorCARIOU, Erwann
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorGRIFFIER, Romain
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorORIEUX, Arthur
dc.contributor.authorSILVA, Stein
dc.contributor.authorFAGUER, Stanislas
dc.contributor.authorSEGUIN, Thierry
dc.contributor.authorNSEIR, Saad
dc.contributor.authorCANET, Emmanuel
dc.contributor.authorDESCLAUX, Arnaud
dc.contributor.authorSOUWEINE, Bertrand
dc.contributor.authorKLOUCHE, Kada
dc.contributor.authorGUISSET, Olivier
dc.contributor.authorPILLOT, Jerome
dc.contributor.authorPICARD, Walter
dc.contributor.authorSAGHI, Tahar
dc.contributor.authorDELOBEL, Pierre
dc.contributor.authorGRUSON, Didier
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorPREVEL, Renaud
hal.structure.identifierCentre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] [CRCTB]
dc.contributor.authorBOYER, Alexandre
dc.date.accessioned2024-05-14T09:09:06Z
dc.date.available2024-05-14T09:09:06Z
dc.date.issued2023-03-24
dc.identifier.issn2110-5820en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/199819
dc.description.abstractEnBACKGROUND: The rise in antimicrobial resistance is a global threat responsible for about 33,000 deaths in 2015 with a particular concern for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and has led to a major increase in the use of carbapenems, last-resort antibiotics. METHODS: In this retrospective propensity-weighted multicenter observational study conducted in 11 ICUs, the purpose was to assess the efficacy of non carbapenem regimen (piperacillin-tazobactam (PTZ) + aminoglycosides or 3rd-generation cephalosporin (3GC) + aminoglycosides) as empiric therapy in comparison with carbapenem in extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) urinary septic shock. The primary outcome was Day-30 mortality. RESULTS: Among 156 patients included in this study, 69 received a carbapenem and 87 received non carbapenem antibiotics as empiric treatment. Baseline clinical characteristics were similar between the two groups. Patients who received carbapenem had similar Day-30 mortality (10/69 (15%) vs 6/87 (7%), OR = 1.99 [0.55; 5.34] p = 0.16), illness severity, resolution of septic shock, and ESBL-E infection recurrence rates than patients who received an empiric non carbapenem therapy. The rates of secondary infection with C. difficile were comparable. CONCLUSIONS: In ESBL-E urinary septic shock, empiric treatment with a non carbapenem regimen, including systematically aminoglycosides, was not associated with higher mortality, compared to a carbapenem regimen.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subject.enAminoglycosides
dc.subject.enAntimicrobial resistance
dc.subject.enExtended-spectrum β-lactamase-producing Enterobacterales
dc.subject.enNon carbapenem β-lactam therapy
dc.subject.enSeptic shock
dc.subject.enUrinary tract infection
dc.title.enEfficacy of carbapenem vs non carbapenem beta-lactam therapy as empiric antimicrobial therapy in patients with extended-spectrum beta-lactamase-producing Enterobacterales urinary septic shock: a propensity-weighted multicenter cohort study
dc.title.alternativeAnn Intensive Careen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1186/s13613-023-01106-zen_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed36959425en_US
bordeaux.journalAnnals of Intensive Careen_US
bordeaux.page22en_US
bordeaux.volume13en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue1en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamAHEAD_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Annals%20of%20Intensive%20Care&rft.date=2023-03-24&rft.volume=13&rft.issue=1&rft.spage=22&rft.epage=22&rft.eissn=2110-5820&rft.issn=2110-5820&rft.au=CARIOU,%20Erwann&GRIFFIER,%20Romain&ORIEUX,%20Arthur&SILVA,%20Stein&FAGUER,%20Stanislas&rft.genre=article


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